Sella turcica bridging as a potential diagnostic tool for dental anomalies: A retrospective cross-sectional study at university dental hospital

BACKGROUND

A lateral cephalogram is an essential diagnostic record for an orthodontist. It is used for diagnosis and treatment planning. This can be a prediction tool as well for developing anomalies of the skeletal, dental, and soft tissues of the head and neck. The sella turcica (ST), being a central landmark for cephalometric assessment, has great importance in itself as a diagnostic parameter to predict certain dental problems related to its bridging.

AIM OF THE STUDY

1. To assess and compare the shape, size, and bridging of ST in subjects of Taif with different skeletal classifications. 2. To find whether there is any association between dental anomalies and sella turcica bridging (STB).

MATERIALS AND METHODS

The study obtained ethical approval from the research ethics committee of Taif University with application no. 44-354 and with no. HAO-02-T-1 dated June 4, 2023. The study involved 87 study samples, divided as follows: a. Group 1: 49 control records. b. Group 2: 38 case records with STB.

RESULTS

The results of our study were promising in relation to STB and the occurrence of dental anomalies in both the case and the control with the frequencies of occurrence being 46.94% and 36.84%, respectively. It was found that the percentage of distribution was more among class I malocclusions and least in class III. It is imperative that impaction (13.8%) is the most associated anomaly, followed by ectopic eruption (11.5%). Supernumerary teeth and gemination were the least associated with STB, and only 1% of the cases showed an association. Statistically significant associations were found for all types of dental anomalies as a result of distribution among cases and controls.

CONCLUSION

Orthodontists commonly employ lateral cephalograms as a regular practice to aid in diagnosis and treatment planning. Furthermore, these cephalograms can serve as predictive tools for dental anomalies. Detecting skeletal abnormalities at an early stage can provide insight into the likelihood of future dental anomalies, enabling clinicians to implement preventive measures accordingly.

Dental anomalies in craniofacial microsomia and condylo-mandibular dysplasia: A retrospective study of 103 patients

INTRODUCTION

Craniofacial microsomia (CFM) and camel-hump condylo-mandibular dysplasia (CMD) are developmental disorders affecting the mandible that share common clinical features. This study aimed to investigate and compare the dental anomalies (DA) between the two entities for differential diagnosis and to propose appropriate treatment.

METHODS

This retrospective cross-sectional study was based on panoramic radiographs of patients diagnosed with CFM or CMD. DA were evaluated using the classification reported by Bilge. Delayed tooth eruption on the affected side was noted based on a comparison with the contralateral side. Nolla's stages of tooth calcification were used to assess dental development.

RESULTS

A total of 103 patients were included, 80 subjects (77.7 %) in CFM group and 23 patients (22.3 %) in CMD group. The prevalence of DA among CFM and CMD-affected patients were 80.0 % and 95.7 %, respectively. Tooth ectopia, tooth impaction, dental development delay, and delayed tooth eruption on the affected side exhibited a significant association with the two craniofacial malformations. The overall affected teeth (molars, premolars, canines) differed between the two craniofacial malformations. Dental abnormalities such as oligodontia, hyperdontia, dentin dysplasia, and anomalies of shape were seen only in subjects affected by CFM.

CONCLUSION

DA were widely observed in patients with CFM and CMD. The global distribution of affected teeth differed between the two conditions and some DA were detected only in CFM patients. When clinical diagnosis remains uncertain, some specific radiological characteristics of DA can be used to differentiate CFM from CMD.

Oculo-facio-cardio-dental (OFCD) syndrome: a case report

BACKGROUND

Oculo-facio-cardio-dental (OFCD) syndrome is a rare condition that affects the eyes, face, heart, and teeth of patients. One notable dental characteristic of OFCD is radiculomegaly, or root gigantism, which highlights the role of dentists in detecting this syndrome. OFCD is an X-linked dominant syndrome that results from a variant in the BCOR gene. Our study presents the first documented case of OFCD in Vietnam and reports a novel BCOR gene variant observed in this case.

CASE PRESENTATION

A 19-year-old Vietnamese female patient with an extremely long root with an abscess was clinically examined for the expression of OFCDs. The radiograph and the variant in BCOR gene were also evaluated. We identified abnormalities in the teeth, as well as ocular, facial, and cardiac features, with radiculomegaly of the canines being a specific symptom for OFCDs. The patient's genetic analysis revealed a pathogenic heterozygous deletion at intron 11 of the BCOR gene, representing a novel variant.

CONCLUSION

Oculo-facio-cardio-dental syndrome (OFCD) is an extremely rare condition characterized by abnormalities in the eyes, face, heart, and teeth, often caused by variants in the BCOR gene. Radiculomegaly, or enlarged dental roots, is a key diagnostic feature of OFCD, and early detection is crucial for preventing future dental complications.

Delayed eruption of permanent maxillary first molars among Saudi children: A cross-sectional study

Aim

This retrospective cross-sectional study aimed to determine the prevalence of delayed development and eruption of permanent maxillary first molars (U6) and associated dental anomalies in a sample of Saudi children.

Material and methods

In total, 10,232 panoramic radiographs from 9,672 patients were screened for delayed U6 eruption. Radiographs showing delayed U6 eruption were further examined for associated dental anomalies. The dental age of participants was estimated using The London Atlas of Human Tooth Development and Eruption.

Result

Twenty cases of delayed U6 eruption were found, with a prevalence of 0.2%. Of these patients, 3 and 17 were males and females, respectively; 9 and 11 cases were unilateral and bilateral, respectively. Congenital absence of the adjacent permanent second molar was observed in 8 cases, and the congenital absence of permanent teeth, except the adjacent second permanent molar and third molar, was observed in 6 cases. Peg-shaped lateral incisors were observed in 6 females. No significant associations were observed between delayed U6 eruption and dental anomalies. Overall, the average delayed U6 eruption was 2.3 years for males and 2.8 years for females.

Conclusion

Among a sample of Saudi children, the prevalence of delayed U6 eruption was 1 in 483 (0.2%) and five times higher in females. No significant associations were found between delayed U6 eruption and dental anomalies; however, congenital absence of the adjacent permanent second molar was observed in 40% of cases.

Radiographic assessment of unerupted permanent maxillary canines and their relationship to the phases of dentition in mixed dentition Spanish children: a retrospective cross-sectional study

PURPOSE

Evaluate if there is a significant association between the position and inclination of the unerupted maxillary canine measured on a panoramic radiograph, and their relationship to gender, age of the patient and stage of dentition.

METHODS

138 panoramic radiographs were examined for this retrospective cross-sectional investigation. Only patients living in Madrid, Spain with mixed dentition were included. These measurements were performed on radiographs, considering the inclination and position of the maxillary canines with regards to the midline, and height with respect to the occlusal plane. Spearman's correlation coefficient was used to analyze the relation among the canine angle and height. p < 0.05 was considered to be significant.

RESULTS

The prevalence of patients with an altered canine angle was 10%, while 43.5% had an apparently abnormal position (overlapping at least half of the adjacent lateral incisor root). No statistically significant association was found between these two variables. In 5% of the patients, the maxillary canine was with an anomalous angle and position. Significant differences were obtained when comparing canine height between children with ectopic canines and normal canines (p = 0.032).

CONCLUSION

No significant association was found between the position and inclination of the unerupted maxillary canine in our sample. Ectopic maxillary canines had a higher incidence in girls, although we did not find statistically significant differences between genders. We observed a higher prevalence of abnormal position and inclination of the permanent maxillary canine in early mixed dentition. Maxillary canines were significantly elevated, further from the occlusal plane, in children with ectopic canines.

Fluctuating asymmetry in third molar agenesis as an aid to estimate socioeconomic status

Traditionally, dental identification techniques are used to establish identity or assist in reconstructing an individual's biological profile. However, other aspects of identity, namely socioeconomic status (SES), can be estimated through teeth. This work aims to evaluate the influence of SES on third molar agenesis in a Portuguese population. X-rays from 448 subjects (223 belonging to a high and 225 to a low socioeconomic status) were assessed and demographic data (age, sex) and dental history were registered. Frequencies and associations between the variables were analyzed using the chi-square test. For each group, differences between third molar agenesis were studied using the Wilcoxon test. The significance level was 5%. X-rays displaying at least one agenesis were more common in females (in both SES groups). Differences between socioeconomic status were found in female subjects' upper right and lower left third molars, with a higher frequency of agenesis in the lower SES group. Agenesis of lower third molars displayed fluctuant asymmetry in both groups, whereas agenesis of upper third molars was also present in the lower SES group. These results suggest that socioeconomic status can affect third molar agenesis prevalence, and fluctuant asymmetry seems more prevalent in the lower SES, as it affects all third molars.

Variation of Tooth Crown Size in Cleft Lip and Palate Patients

AIM

This study aims to compare the mesiodistal (MD) and buccolingual (BL) tooth crown size (TCS) of adult patients with cleft lip and palate (CL/P) and patients without CL/P.

MATERIALS AND METHODS

The sample of this study consisted of 146 adult patients, of both genders, of which 73 were included in the case group (with CL/P) and 73 were included in the control group (without CL/P). Data regarding gender and age and cleft type were collected. In addition, dental models were evaluated to obtain the TCS in the maximum distance of the MD and BL dimensions of all erupted permanent teeth (except third molars). The results were submitted to statistical analysis with a significance level of 0.05.

RESULTS

In the upper arch, the central incisors (CI) were smaller in the case group for the MD and BL dimensions (p < 0.05). The lateral incisors (LI) and canine (C) were smaller only in the BL width (p < 0.05) and the second molars (SM), were smaller only in the MD dimensions. In the lower arch, there were significant differences only in the BL width between groups, the CI and LI presented smaller measurements in CL/P patients, while the left first molar (FM) and right first premolar (FPM) were larger (p < 0.05) than in patients without CL/P.

CONCLUSION

Patients with CL/P have different sizes in certain teeth compared to patients without CL/P.

CLINICAL RELEVANCE

Cleft lip and palate patients usually present important dental anomalies; thereby, the knowledge about trends in tooth size variations in CL/P patients can aid in dental and orthodontic treatment planning to obtain a stable, functional, and esthetic occlusion.

Dental anomalies in an Albanian orthodontic sample: a retrospective study

BACKGROUND

To evaluate the prevalence and the distribution of dental anomalies in an Albanian orthodontic sample.

METHODS

For this retrospective study, a sample of panoramic radiographs (PR) of n. 779 (456 F and 323 M, mean age of 15.1 ± 5.5 years) Albanian subjects with no genetic syndromes or craniofacial malformations (e.g., cleft lip/palate), history of extraction, trauma or previous orthodontic treatment drawn from the archives of the University Dental Clinic Our Lady of Good Counsel, was examined. The inclusion criteria were: subjects from 8 to 30 years of age, good quality of PRs in order to allow the assessment of crown and root development. For different dental anomalies, both the prevalence and the association were evaluated by using Chi-square test (p < 0.05).

RESULTS

24.4% of the sample had at least one dental anomaly and 4.6% had more than one. The following dental anomalies were most prevalent: hypodontia (9.8%), dental impaction (7.6%), and ectopic eruption (5.3%). No statistically significant correlation was found between males and females (p > 0.05).

CONCLUSIONS

The most common anomalies in this group are found to be those of number and position, and only radiological investigations can reveal either of these anomalies. Early diagnosis of dental anomalies can contribute to prevent their complications and to establish the most suitable therapy to achieve a functional occlusion.

Prevalence, classification and dental treatment requirements of dens invaginatus by cone-beam computed tomography

Background

This study aimed the evaluation of the prevalence, characteristics, types of dens invaginatus (DI) and co-observed dental anomalies to understand dental treatment requirements in anterior teeth that are susceptible to developmental anomalies by using cone-beam computed tomography (CBCT).

Methods

In this retrospective study, the anterior teeth of 958 patients were evaluated by using CBCT for the presence of DI. The demographic features, types of DI and treatment requirements were also recorded. The association between sex and the presence of DI was evaluated using chi-squared test.

Results

Seventy-three DI anomalies were detected in the anterior teeth of 49 patients (18 females, 31 males). The frequency of DI was 5.11% and the most frequently involved teeth were lateral (57.53%). Forty-six teeth were classified as Type I (63.01%), 24 as Type II (32.87%), and three as Type III (4.10%). Apical pathosis was found to be 20.54% in all DIs detected and accounted for all Type III and one-third of Type II.

Conclusions

CBCT imaging can be effective in the detection of dental anomalies such as DI and planning for root canal therapy and surgical treatments. Prophylactic interventions might be possible to prevent apical pathosis with the data obtained from CBCT images.

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.

Prevalence of dental anomalies in a sample of growing subjects: a retrospective study

BACKGROUND

dental anomalies are a group of disorders characterized by alterations in tooth number, shape, size, structure, development, and timing of eruption due to genetic and environmental factors.

OBJECTIVES

to identify the prevalence of dental anomalies in a large sample of non-orthodontic subjects.

DESIGN

a retrospective chart review was conducted based on digital panoramic radiographs by two examiners who assessed the presence of displacement of the maxillary canines (DMC), impacted teeth (IT), tooth agenesis (TA), supernumerary/supplementary teeth (ST), and tooth transpositions (TT).

SETTING AND PARTICIPANTS

radiographs of subjects aged between 8 and 18 years were analysed. A chi2 test was employed to assess possible associations between the number and type of dental anomalies and patients' gender. When an association was present, a binary logistic regression was conducted to calculate the odds ratio between the variables. The significance level was set at p<0.05.

RESULTS

a total of 1,124 subjects (25.7%) showed at least one dental anomaly. DMC (12.1%) and IT (12%) were the most frequent dental anomalies. The most represented impacted teeth were the upper canine (9.2%) and the upper central incisor (1.3%). TA was detected in 296 radiographs (6.8%), with 134 showing two or more TA. The prevalence of ST and TT in the total sample was 2.2% and 0.7%, respectively. Associations were found between ST and IT, between TA and DMC, and between TA and IT.

CONCLUSIONS

the results obtained encourage the radiographic investigation of dental anomalies at an early stage.

Analysis of the feasibility of using deep learning for multiclass classification of dental anomalies on panoramic radiographs

The aim of the feasibility study was to construct deep learning models for the classification of multiple dental anomalies in panoramic radiographs. Panoramic radiographs with single supernumerary teeth and/or odontomas were considered the "case" group; panoramic radiographs with no dental anomalies were considered the "control" group. The dataset comprised 150 panoramic radiographs: 50 each of no dental anomalies, single supernumerary teeth, and odontomas. To classify the panoramic radiographs into case and control categories, we employed AlexNet, which is a convolutional neural network model. AlexNet was able to classify whole panoramic radiographs into two or three classes, according to the presence or absence of supernumerary teeth or odontomas. The performance metrics of the three-class classification were 70%, 70.8%, 70%, and 69.7% for accuracy, precision, sensitivity, and F1 score, respectively, in the macro average. These results support the feasibility of using deep learning to detect multiple dental anomalies in panoramic radiographs.

Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation

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.

Rare case of skeletal third class in a subject suffering from Solitary Median Maxillary Central Incisor syndrome (SMMCI) associated to panhypopituitarism

Background

The median solitary maxillary central incisor syndrome (SMMCI) is a rare malformative syndrome consisting of multiple defects, mainly found on the body midline. It can be correlated to the etiopathological and phenotypic pattern of panhypopituitarism. This case-report describes the rare case of a patient suffering from SMMCI and panhypopituitarism, showing an unusual craniofacial morphology.

Case presentation

From the cephalometric analysis, a skeletal class III was identified (despite the other cases described in literature described as skeletal class II), derived from hypomaxillia and mandibular protrusion. A convex lip profile, with tendency to mandibular hyper-divergency, airway patency, anterior and posterior cross-bite were observed. At the clinical examination, a maxillary cant was evident on the frontal plane that appeared asymmetric, with the prevalence of the third lower part of the face. There were some dysmorphic signs such as: small nose, rectilinear eyelid line and reduced interocular distance.

Conclusions

The present clinical case shows how, despite the literature, SMMCI can be associated with a III skeletal class, with maxillary hypoplasia and mandibular protrusion. The interdisciplinary collaboration between dentist and pediatrician is therefore important for the early interception of the malocclusions associated with these syndromes.

Clinical Significance of Talon Cusp in a Mixed Dentition Patient

Talon cusp is a developmental dental anomaly with supernumerary structure projecting from the dento-enamel junction towards the incisal edge of an anterior tooth. The etiology is usually unknown but studies states that talons cusp can occur due to the hyperactivity of the enamel organ during morph differentiation. The incidence is 0.04-10% and the prevalence is more in maxillary incisors than mandibular incisors and more in palatal aspect of the teeth. The most common complications are esthetics, increased risk for caries and occlusal accommodation. This article reports a case of talon cusp on the palatal surface of the permanent maxillary lateral incisor. Due to its clinical significance the dentist should be able to diagnose the supernumerary tooth and definitive treatment should be done.

Prevalence and Distribution of Selected Dental Anomalies in the Patients Reporting to Dental Institute, RIMS, Ranchi

AIM

The purpose of this study was to determine the prevalence of developmental dental anomalies in the East Indian subpopulation.

MATERIALS AND METHODS

The study was based on clinical examination, evaluation of dental casts, and radiographs of 2385 Indian patients (1169 males and 1216 females), who visited Dental Institute, Rajendra Institute of Medical Sciences, Ranchi. These patients were examined for shape anomalies, number anomalies, structural anomalies, and positional anomalies.

RESULTS

It was observed that 5.83% of patients reported with a dental anomaly. Males reported with higher incidence with a male-to-female ratio of 1: 0.96. Microdontia was the most common anomaly. Unilateral microdontia was more common than bilateral and was more prominent in males (9.05%). It was observed that peg laterals were frequently encountered developmental anomaly at 1.34%, while the incidence of amelogenesis imperfecta and dentinogenesis imperfecta was 0.29% and 0.33%, respectively. The present demography reported a very low incidence of dens, fusion, hyperdontia, hypodontia, and macrodontia at <0.01%, whereas anomalies such as transportation, transmigration, and hypodontia of the maxillary molar reported no prevalence.

CONCLUSION

The percentage of dental anomalies although low should be treated as soon as possible to avoid further complications. The results of our study can serve as an indicator to ascertain the pattern of dental anomalies in Jharkhand. This might help to plan the dental treatment of the community.

Radiographic Diagnosis of Systemic Diseases Manifested in Jaws

Radiographic changes of the oral and maxillofacial hard tissues can be an indication of an underlying systemic disease. In this article, the range of individual disease entities that have both systemic and dental manifestations are reviewed. Images for many conditions are provided to illustrate the radiographic changes. A summary of the most common jaw affected, radiographic and pathognomonic findings, and management aspects is listed in a table format within this article for quick reference.

Radiographic Diagnosis in the Pediatric Dental Patient

This article emphasizes the selection criteria for radiographic acquisition in children due to the greater sensitivity of children for radiation compared with adults. Diagnosis of common pediatric dental conditions, including dental caries, periodontitis, dental anomalies, cysts, tumors, and traumatic dental conditions, are discussed with relevant clinical scenarios.

Association of tooth agenesis with dental anomalies in young subjects

AIM

The aim of the current study is to correlate the presence of tooth agenesis with other dental anomalies in 7- to 15-year-old patients.

MATERIALS AND METHODS

After evaluating 4000 panoramic radiographs of young subjects, 430 revealed the presence of tooth agenesis, except for the third molar, and are retrospectively observed and compared with a non-agenesis control group of 500 subjects, in order to investigate the existence of other associated dental anomalies in both groups.

RESULTS

The prevalence of tooth agenesis was approximately 9.30% (430/4000); no significant gender differences were found. A significantly higher prevalence of microdontia of the maxillary lateral incisors (p < 0.001) and delayed tooth development (p = 0.0001) was observed in the agenesis group (group A), while delayed development of permanent teeth (p < 0.0001) and hypo-occlusion of the primary molars (p = 0.0130) were found in the control group (group B).

CONCLUSIONS

Agenesis patients presented a significantly higher prevalence of microdontia of the maxillary lateral incisors. Instead, non-agenesis patients presented a high prevalence of delayed permanent tooth development and hypo-occlusion of the primary molars. Moreover, further researches are needed to elucidate the role of genetics and environmental factors in the current sample group.

BCL11B-related disorder in two canadian children: Expanding the clinical phenotype

The product of the BCL11B (B-Cell Leukemia 11) gene is a bi-functional transcriptional regulator that can act as either a repressor or an activator. It plays an important role in the development of the nervous, immune, and cutaneous systems, and is also involved in dental and craniofacial development. BCL11B-Related Disorder (BCL11BRD) is a novel rare neurodevelopmental disorder associated with mutations in BCL11B. A total of 17 patients have been described in the literature thus far. The main symptoms of BCL11BRD include global developmental delay, speech impairment, dental anomalies, feeding difficulties, refractive errors, dysmorphic features, and immunological abnormalities. In this report, we describe two Canadian girls, with pathogenic de novo BCL11B variants, both diagnosed via exome sequencing. One of the patients had global developmental delay, dental anomalies, dysmorphic features, dyskinesia and hypotonia; the latter two symptoms have not been previously reported in patients with BCL11BRD. She also had dysgenesis of corpus callosum and dilatation of the frontal horns of lateral ventricles, a brain anomaly that has been previously reported in only one other patient. The second patient had developmental delay, dysmorphic features, spasticity in lower limbs and dental anomalies. Our report contributes to the knowledge of the BCL11BRD, expands the clinical phenotype, and can also aid with genetic counseling of newly identified patients.

Imaging features of mucopolysaccharidoses in the head and neck

Ear, Nose and Throat (ENT) involvement by mucopolysaccharidoses is very common, affecting over 90% of patients, and occurs early in the course of the disease. Airway narrowing secondary to glycosaminoglycan deposition results in greatly increased morbidity, mortality and risk of anesthetic complications in these patients. Macroglossia, restricted mouth opening, tracheobronchomalacia, adenotonsillar hypertrophy along with other factors such as a short, rigid and unstable cervical spine, cardiac disease and increased susceptibility to respiratory infections result in a high perioperative mortality and morbidity. Imaging is most beneficial for evaluation of the airway, in particular in patients with obstructive symptoms and prior to intubation. We review the ENT manifestations of mucopolysaccharidoses including airway involvement, otological, oral and dental complications. 3-D reconstructions of the trachea, which is routinely captured on CT imaging of the spine, can be of great value for planning intubation in this patient population.

Dental anomalies as a possible clue of 1p36 deletion syndrome due to germline mosaicism: a case report

Background

Monosomy 1p36 is the most common terminal deletion syndrome with an autosomal dominant pattern of inheritance. This syndrome is defined by an extremely wide spectrum of characteristics; however, developmental delay and intellectual disability of various degree are present in all patients and about the 90% of patients have a severe intellectual disability. Dental agenesis or other dental anomalies have not been described in previous reports.

Case presentation

We report the case of two little sisters born from healthy and non-consanguineous parents, presenting with dental anomalies and one of them with epilepsy, dilated cardiomyopathy with left-ventricular non-compaction, strabismus, history of poor growth, hypotonia and mild language delay. Patients were evaluated in several departments (genetic, child neuropsychiatric, cardiology, odontostomatology, ophthalmology, otorhinolaryngology) of Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy. They underwent investigations such as electrocardiogram, echocardiogram, dental orthopantomography X-Ray and Computed Tomography, electroencephalograms, abdomen ultrasound, blood tests, IQ tests, genetic analysis. They both have an Intelligence Quotient greater than 70 and a negative neurologic exam. Each sister carries the same 1p36 deletion of about 2.3 Mb. Genetic analysis of the parents’ blood samples (Single Nucleotide Polymorphism- array, karyotype and Fluorescent In Situ Hybridization) did not reveal any deletion, translocation or inversion and confirmed the paternity. A third sib of the probands does not carry the 1p36 deletion or other quantitative alterations.

Conclusion

This report describes a new trait linked to monosomy 1p36, namely a mild intellectual outcome associated with significant dental anomalies. Our finding suggests that 1p36 deletion syndrome may present with a mild cognitive impairment or even with a normal intellectual development: this is very important for the genetic counselling, especially in a prenatal setting. Moreover, we report the third study with recurrent 1p36 deletion syndrome in two siblings, likely due to germline mosaicism. Finally, we believe that the dental anomalies should be investigated in 1p36 deletion syndrome and that the spectrum of the condition could be broader than we assume.

Dental anomalies and orthodontic characteristics in patients with pseudohypoparathyroidism

Background

Pseudohypoparathyroidism (PHP) is a rare and inherited disease caused by mutations in the GNAS-gene or upstream of the GNAS complex locus. It is characterized by end-organ resistance to PTH, resulting in hypocalcemia and hyperphosphatemia. We aimed to investigate the dental anomalies according to tooth types and the orthodontic characteristics of patients with PHP.

Methods

Using a cross-sectional design, 29 patients (23 females) with PHP, living in Denmark, were included, and their clinical intraoral photos and radiographs were examined.

Results

Pulp calcification was found in 76% of the patients. Blunting of root apex was present in 55% and shortening of root in 48% of the examined patients. Blunting and shortening of roots were seen more often in premolars than in other tooth types (p_both < 0.01). Crowding of lower anterior teeth was frequently observed (36%) as well as diastema in the upper arch (25%), midline diastema (18%), and Class III malocclusion (11%).

Conclusion

In the present study population, the teeth were frequently affected by pulp calcification and/or deviation of the root morphology. Blunting and shortening of root(s) were more often seen in premolars than in other tooth types. Class III malocclusion was relatively prevalent. It is important to pay attention to dental anomalies and occlusion in order to provide adequate care for patients with PHP.

Vital bleaching for children with dental anomalies: EAPD members' survey

AIM

Understand EAPD members' practices of vital bleaching for children with dental anomalies.

METHODS

An anonymous online survey sent via EAPD in January 2019, consisting of 13 questions with possible multiple answers and free text.

RESULTS

110 responses from 24 countries were obtained. The majority worked in hospitals/universities (n = 69, 63%) or private practices (n = 50, 46%) and were specialists (n = 62, 57%) or senior academics (n = 35, 32%). Most respondents (n = 74 68%) did not provide vital bleaching for children. 88 respondents (80%) belonged to EU: of these, 46 (52%) were not aware of bleaching regulations. For respondents who provided bleaching 26 (72%) undertook home bleaching, using 10% carbamide peroxide (n = 21, 58%), most commonly for 2 weeks (n = 14, 39%), following establishment of the permanent dentition (n = 21, 58%). Deciding factors included: extent (n = 27, 75%) and shade (n = 26, 72%) of discolouration and child being teased by peers (n = 23, 64%). Main reasons for not bleaching included: concerns with side effects (n = 41; 55%) and not agreeing with bleaching (n = 23, 31%). Dentists who did not bleach managed a range of conditions, most frequently molar-incisor hypomineralisation (n = 57; 77%). The majority provided composite restorations with removal of tooth structure (n = 50; 68%) with a number opting for no treatment (n = 27, 37%).

CONCLUSION

This study shows wide variations in treatment of children's dental anomalies across Europe. Fears of adverse effects and personal beliefs seemed to be the main deterrents to bleaching in children. Clinicians who provided bleaching tended to opt for more conservative techniques and to take children's concerns into consideration.

A systematic review of relative indications and contra-indications for prescribing panoramic radiographs in dental paediatric patients

PURPOSE

To systematically review the evidence of the diagnostic efficacy of panoramic radiographs (PRs) in the following six clinical situations: caries, acute dental infections, dental trauma, dental anomalies, Developmental disorders and pathological conditions in children. The research question posed by the EAPD was: "In which clinical situations and age groups is it indicated/contra-indicated to prescribe PRs in relation to these six clinical situations, in children".

METHODS

An electronic search of the following databases was conducted: MEDLINE via OVID, EMBASE via OVID, The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE) and the Cochrane Health Technology Assessment (HTA), to identify relevant studies published from 1990 to 2018. The systematic review was performed according to the PRISMA guidelines. Study screening, data extraction and risk of bias assessment of included studies was carried out independently and in duplicate using the QUADAS 2 tool.

RESULTS

The search resulted in 3420 potentially relevant studies, and following screening 175 full texts were obtained, of which 16 were finally included in the review. Meta-analysis was not possible for any of the aforementioned clinical situations, therefore the included studies were tabulated in terms of qualitative descriptive hierarchy of evidence for diagnostic.

CONCLUSION

Based on currently available evidence there is a need for high quality diagnostic accuracy efficacy studies to address important diagnostic tasks in these six clinical situations in children, as there is a lack of scientific evidence concerning PRs in children, as there would support the production of guidelines for prescribing PRs in children along with their relative indications and contra-indications.

Evaluation of sphenoid sinus variations by using cone beam computed tomography in patients with cleft lip/palate

OBJECTIVE

The purpose of this study is to evaluate the sphenoid sinus variations in patients with cleft lip/palate.

METHODS

Sixty three (63) patient's cone beam computed tomography (CBCT) images, taken from the head and neck region, were evaluated. Images were divided into two groups; [Group 1; patients with cleft lip/palate (CLP Group) (n = 23) Group 2; patients without cleft lip/palate (control group) (n = 40)]. The main pneumatization types (conchal, sellar, and presellar) of sphenoid sinuses were assessed on sagittal sections of the CBCT images. The sphenoid body, lateral and lesserwing types were evaluated on coronal sections and anterior type pneumatization was evaluated on axial sections.

RESULTS

The mean age ranged from 12 to 26 (16.57 ± 4.46) in Group 1 and 12 to 25 (16.58 ± 3.71) in Group 2. In both groups, the male and female distribution was found similar (P = 0.342). The sellar type was the most common pneumatization type of sphenoid sinus both for the Group 1 (91.3%) and Group 2 (80%). Any statistically significant difference was not found between the two groups in terms of the incidence of pneumatization types. Combined type pneumatization was detected in 65.6% of the Control group and 76.2% of the CLP group.

CONCLUSIONS

In this study, the prevalence of sphenoid sinus pneumatization types in CLP patients was compared with the normal population. Any significant difference was not determined in the two groups.

BMP4 mutations in tooth agenesis and low bone mass

OBJECTIVE

To identify an uncommon genetic cause of tooth agenesis (TA) by utilizing whole exome sequencing (WES) and targeted Sanger sequencing in a cohort of 120 patients with isolated TA.

DESIGN

One deleterious mutation in the gene encoding bone morphogenetic protein 4 (BMP4) was identified in 6 unrelated patients with TA by WES. After that, the coding exons of BMP4 were examined in 114 TA patients using Sanger sequencing. Dual-energy X-ray absorptiometry (DEXA) was used to measure the bone mineral density of patients who carried a BMP4 mutation. Finally, preliminary functional studies of two BMP4 mutants were performed.

RESULTS

We detected 3 novel missense mutations (c.58 G > A: p.Gly20Ser, c.326 G > T: p.Arg109Leu and c.614 T > C: p.Val205Ala) and 1 reported mutation in the BMP4 gene among 120 TA probands. The previously reported BMP4 mutation (c.751C > T: p.His251Tyr) was associated with urethra and eye anomalies. By extending the pedigrees, we determined that the tooth phenotypes had an autosomal dominant inheritance pattern, as individuals carrying a BMP4 mutation exhibit different types of dental anomalies. Interestingly, we observed that patients harboring a BMP4 mutation manifested early onset osteopenia or osteoporosis. Further in vitro functional assays demonstrated that two BMP4 mutants resulted in a decreased activation of Smad signaling. Therefore, a loss-of-function in BMP4 may contribute to the clinical phenotypes seen in this study.

CONCLUSIONS

We identified 4 mutations in the BMP4 gene in 120 TA patients. To our knowledge, this is the first study to describe human skeletal diseases associated with BMP4 mutations.

Epidemiology of Malocclusion in 3,491 Subjects Attending Public Dental Service in Rome (Italy): Evaluation of the Orthodontic Treatment Need Index

AIM

The objective of this epidemiological survey is to investigate the dental-skeletal features of subjects attending the Public Dental Service in Unità Operativa Complessa (UOC) (Orthodontic Department of "La Sapienza University of Rome") and compare them with the existing body of evidence obtained from other surveys. Accordingly, the Index of Orthodontic Treatment Need (IOTN) was employed, in order to achieve a common framework to allow the shaping of public health prevention practices.

MATERIALS AND METHODS

A sample of 3,491 subjects in the Orthodontic Department of "La Sapienza-University of Rome" (UOC) was evaluated with the adoption of IOTN to define malocclusion severity.

RESULTS

In the result analysis, it was observed that class II malocclusion was more frequent in the sample (40%), and a large part of the examined population also presented mandibular dental crowding (43%), increased overjet (41%), and increased overbite (38%). Only 26.44% (20.17% IOTN 4; 6.27% IOTN 5) had strong need for orthodontic treatment.

CONCLUSION

The realization of epidemiological investigations to establish priority for treatment need is, therefore, particularly useful, not only to estimate the prevalence of some clinical conditions in the observed population, but also to plan targeted interventions, such as interceptive and corrective therapies in growing children.

CLINICAL SIGNIFICANCE

These interventions could solve specific clinical situations and/or prevent their escalation. Only in this way, it is possible to avoid fragmentation of the limited resources available, using them for patients with an objective need.

Developmental dental anomalies and their potential role in establishing identity in post-mortem cases: a review

Teeth may provide useful forensic evidence owing to features like uniqueness, stability and comparability. Moreover, the human dentition is heterodont, i.e. all the teeth have different morphology - incisors, canines, premolars and molars. There are sometimes deviations from normal morphology, such as the presence of extra teeth, variation in their shape and size eg the presence of an extra cusp, fractured crown/root, Carabelli's cusp, peg laterals, transpositions, fusion, etc. These differences can help forensic personnel identify bodies, especially where other methods of identification like facial features, fingerprints or DNA typing cannot yield satisfactory results as in cases of badly decomposed bodies, burnt remains, mass disasters, etc. Identification from dentition is based on the direct comparison of post-mortem dental profiles with ante-mortem dental records of the deceased. This article aims to review these developmental and morphological dental traits and their role in post-mortem identification.

Protocol GenoDENT: Implementation of a New NGS Panel for Molecular Diagnosis of Genetic Disorders with Orodental Involvement

Rare genetic disorders are often challenging to diagnose. Anomalies of tooth number, shape, size, mineralized tissue structure, eruption, and resorption may exist as isolated symptoms or diseases but are often part of the clinical synopsis of numerous syndromes (Bloch-Zupan A, Sedano H, Scully C. Dento/oro/craniofacial anomalies and genetics, 1st edn. Elsevier, Boston, MA, 2012). Concerning amelogenesis imperfecta (AI), for example, mutations in a number of genes have been reported to cause isolated AI, including AMELX, ENAM, KLK4, MMP20, FAM83H, WDR72, C4orf26, SLC24A4, and LAMB3. In addition, many other genes such as DLX3, CNNM4, ROGDI, FAM20A, STIM1, ORAI1, and LTBP3 have been shown to be involved in developmental syndromes with enamel defects. The clinical presentation of the enamel phenotype (hypoplastic, hypomineralized, hypomature, or a combination of severities) alone does not allow a reliable prediction of possible causative genetic mutations. Understanding the potential genetic cause(s) of rare diseases is critical for overall health management of affected patient. One effective strategy to reach a genetic diagnosis is to sequence a selected gene panel chosen for a determined range of phenotypes. Here we describe a laboratory protocol to set up a specific gene panel for orodental diseases.

What factors affect the severity of permanent tooth impaction?

BACKGROUND

The aim of this study was to investigate the association between the severity of permanent tooth impaction and a number of predefined factors, including tooth type, age, gender, tooth agenesis, microdontia of maxillary lateral incisor, and retained deciduous predecessors.

METHODS

A sample of 2979 dental patients, aged 15 to 40 years, was surveyed by two calibrated examiners for permanent tooth impaction (excluding third molars). On panoramic radiographs, the impacted teeth were initially ranked based on their vertical, horizontal, and angular positions, and the ranking was then analysed for distribution by the predefined factors. To test the age factor, patients were divided into younger (15 to 25 yr) and older (between 25 and 40 yr) age groups. The statistical significance of the ranked vertical, horizontal, and angular positions of impacted teeth by the investigated factors was determined using the Wilcoxon-Mann-Whitney U test.

RESULTS

The angular position of the impacted teeth was more severe in the older age group (P = 0.012) and in females (P = 0.018). The maxillary canine had more severe horizontal (P = 0.001) and angular (P = 0.003) impactions in females. Tooth agenesis was associated with less severe horizontal impaction (P = 0.041) in the mandibular second premolar. In addition, microdontia of the maxillary lateral incisor was associated with more severe horizontal impaction in general, and more severe horizontal (P = 0.024) and angular (P = 0.010) impaction of the mandibular second premolar in particular. Finally, our results showed that a retained deciduous predecessor was linked to a less severe vertical impaction of the mandibular second premolar (P = 0.030) and horizontal impaction of the maxillary second premolar (P = 0.037) but more severe angular impaction of the mandibular canine.

CONCLUSIONS

This study suggests that the more delayed the treatment, being a female, the presence of maxillary lateral incisor with microdontia, and retained lower deciduous canines might be associated with more severe position of the impacted teeth. Because the severity of tooth impaction would follow different patterns when considering the investigated factors, it is mandatory to include such factors during dental diagnoses and the planning of preventive or interceptive interventions for young patients.

Long-term Dental Anomalies after Pediatric Cancer Treatment in Children

Objective:

The aim of this study is to determine the frequency of dental anomalies (DAs) (microdontia, hypodontia, hyperdontia, enamel defect, root malformation) in pediatric cancer patients at the ages <5 years and between 5 and 7 years, and understand their relationship with the received therapy.

Materials and Methods:

Pediatric patients who were diagnosed with cancer and treated before the age of 7 years were investigated in a case- control design. The study included 93 pediatric patients whose ages at diagnosis were between 9 months and 7 years and whose treatments were completed before 5-8 years. Group A consisted of patients in the age range of 9 months to 4 years and Group B consisted of patients in the age range of 5-7 years. Seventy-two siblings with compatible dental age ranges were included in the control group. For both groups, intraoral examinations were performed and panoramic radiographs were taken.

Results:

Among the 93 pediatric patients, the mean age was 9.54±1.25 (range: 8-13 years) and 48 (51.6%) patients were male. The most common diagnosis was hematologic malignancy with a rate of 65.5%. At least one DA was detected in 7 (9.7%) individuals of the control group and in 78 (83.9%) of the patient group. While the patients in the study group had all kinds of DAs, those in the control group had only enamel defects. The rates of microdontia (p=0.077) and hypodontia (p=0.058) were detected to be significantly higher in Group A than in Group B. Root malformation was more common in patients receiving chemotherapy and radiotherapy than in those receiving only chemotherapy (p=0.006).

Conclusion:

In this study it was found that the pediatric patients who received cancer treatment before the age of 7 years constituted a high-risk group for DAs. The frequencies of microdontia and hypodontia were increased even more when the patient was treated for cancer before 5 years of age.

Dental anomalies and their treatment modalities/planning in orthodontic patients

OBJECTIVE

This study was carried to study the prevalence of dental anomalies and treatment modalities/planning among the orthodontic patients.

MATERIALS AND METHODS

A total of 370 orthodontic records including their pre-treatment orthopantomographs (OPG) and study models of orthodontic patients in permanent dentition who attended dental clinic were assessed for impaction, hypodontia, supernumerary, supraocclusion, infraocclusion, and any other anomalies excluding the third molars. The association of anomalies with gender status and racial status was analyzed using Pearson's Chi-square test. A P value of <0.05 is considered as significant. The confidence interval at 95% (CI) was set.

RESULTS

Among the 370 subjects, 105 (28.4%) presented with at least one anomaly. Eighty-five (23%) demonstrated a single anomaly and 20 (5.4%) with more than one anomaly. The most prevalent anomaly was impaction (14.32%), followed by hypodontia (7.03%). The less common anomalies were microdontia (1.08%), dilacerations (0.27%), and generalised enamel hypoplasia (0.27%). Maxillary right lateral incisors and canines were the most common affected teeth and these are located on the maxillary right quadrant. It was evident that dental anomalies were statistically dependant on race (P = 0.025), but independent of gender. The most common treatment planned for these patients was fixed appliance.

CONCLUSIONS

Impaction was predominant among 28.4% subjects observed with anomaly and most patients with anomaly are treated with fixed appliances (49%).

CLINICAL RELEVANCE

These anomalies play a great role in occlusion and alignment in treatment planning and relapse for orthodontic treatment.

Prevalence of dental anomalies in French orthodontic patients: A retrospective study

OBJECTIVES

To investigate the prevalence and gender distributions of dental anomalies in French orthodontic patients.

MATERIAL AND METHODS

A retrospective review of the dental files of orthodontic patients was conducted to investigate the frequencies of dental anomalies. Pretreatment intraoral photographs and panoramic radiographs were analyzed. The occurrence rates of various dental anomalies (as determined by the numbers, shapes, structures, exfoliations, and eruptions of teeth) were calculated as percentages and differences in gender distribution using Chi² and Fisher tests.

RESULTS

Five hundred fifty-one patients receiving orthodontic treatment between 2003 and 2013 at a French hospital were included in the study: 45.74% of the patients (n=252) presented at least one dental anomaly. Taurodontism was the most common (15.06%), followed by ectopic eruption (11.43%). Odontoma, macrodontia, fusion, gemination, talon cusp, dentinogenesis imperfecta, regional odontodysplasia, premature tooth eruption, and premature exfoliation were not found. No statistically significant correlations were found between gender and the occurrence of dental anomalies.

CONCLUSION

French orthodontic patients exhibit a high rate of dental anomalies, indicating that dental anomalies should be carefully considered in the orodental management of French patients.

The Association between Ponticulus Posticus and Dental Agenesis: A Retrospective Study

Objective:

Neural tube defects may increase the risk of an abnormal development of skull, vertebral column and teeth formation, including dental agenesis in non syndromic patients. The association between the presence of a congenital Dental Agenesis (DA) and the Atlantooccipital Ligament (AOL) calcification, known as “Ponticulus Posticus” (PP), as possible links can be investigated.

Design:

After a systematic review of the scientific literature on this topic, two independent examiners assessed the AOL calcification in lateral cephalograms of 350 non syndromic patients(7-21 years old). The results were compared with a control group (non syndromic patients, without congenital missing teeth).

Results:

The 16.3% of the population studied by cephalometric analysis revealed a prevalence rate of PP (both complete and partial) with a slight male predominance is seen, not statistically significant (χ square test = 0.09; p= 0.76). In both sexes complete PP is more observed. In the patients affected by DA the frequency of PP is the 66.6% (both complete than partial). The χ square test with Yates correction showed a significative difference(χ= 66.20; p value= 0.00) between PP in patients with DA compared to not affected by DA.

Conclusions:

PP is not an uncommon anomaly. Since orofacial pain like migraine and other symptoms are often associated to PP, during routine radiographic examination, if detected, it should be documented in patients’ health record and with symptoms, further investigation should be sought for. These findings encourage to think there’s an association between DA in non syndromic patients and neuro-crestal cells defects.

Long-Term Effects of Acute Myeloid Leukemia Treatment on the Oral System in a Pediatric Patient

Introduction:

Acute Myeloid Leukemia (AML) in pediatric patients is a serious disease, although, for the subgroup of patients who receive proper treatment, a long-term survival rate above 50% is typical. The cycles of chemo- and radiotherapy used to treat AML can impair dental development.

Case Report:

Herein, we describe the oral condition of a 25-year-old male patient treated for AML with chemo- and radiotherapy from 5 to 7 years of age; his AML has remained in remission for the past 18 years. He had lost only one permanent tooth, but the remaining teeth demonstrated serious deformations and radicular hypoplasia. Two teeth required immediate extraction and subsequent replacement by implant-supported crowns. We found that the decayed, missing, filled teeth (DMFT) index was not representative of the real oral condition. Here, we report the full case and provide a brief review of the literature.

Conclusion:

Antitumor treatment of pediatric leukemia can induce total impairment of dental development and function. These adverse effects may become clinically evident many years after the resolution of cancer, and can be significantly detrimental to the patient’s quality of life.

Temporomandibular disorders and psychosocial status in osteogenesis imperfecta - a cross-sectional study

Background

Osteogenesis Imperfecta (OI) is characterized by a number of deviations in the orofacial region. The aims of the present study were to investigate the occurrence of temporomandibular disorders, to evaluate the psychosocial status, and to assess the dental occlusion in a population of adult OI patients.

Methods

Participants (n = 75) were classified with mild OI, type I (n = 56), or moderate-severe OI, type III and IV (n = 19). OI patients were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (axis I and II).

Results

Temporomandibular disorders and functional limitations in the orofacial region were rare and did not differ between patients with mild and moderate-severe OI (P > 0.050). No significant differences between Graded Chronic Pain Scale grades 0, 1, and 2 were found in mild OI vs. moderate-severe OI (P > 0.160). Few patients (16%) had signs of depression, but close to half (48%) had signs of somatization. Patients with moderate-severe OI had a lower mean number of teeth compared to patients with mild OI (P <  0.050). In general, malocclusions were prevalent, and mandibular overjet and posterior cross-bite were found more often in moderate-severe OI compared with mild (P <  0.050).

Conclusions

Patients with moderate-severe OI had more malocclusions than patients with mild OI. The psychosocial status of OI patients was remarkably healthy considering the severity of this disabling systemic disorder. The bodily pain complaints frequently reported in OI patients were not largely reflected in the orofacial area as painful temporomandibular disorders.

Primary Fused Teeth and Findings in Permanent Dentition

OBJECTIVE

The aim of this study was to investigate the characteristics of primary fused teeth (PFT) and their effect on permanent dentition in a group of Turkish children.

SUBJECTS AND METHODS

Dental records of 13,450 pediatric patients who attended the Pediatric Dental Clinic in northern Turkey between 2015 and 2017 were reviewed. Forty patients had been diagnosed with PFT and were included in the study. Clinical and radiographic examinations were conducted, and the distribution of PFT was calculated by type, sex, affected jaw, associated dental anomalies, and clinical complications. Data analysis involved descriptive statistics.

RESULTS

A total of 50 PFT were detected in the 40 patients. The mean age of patients was 6.7 ± 0.3 years (range 3-10 years). The most common PFT were the mandibular lateral incisors and canines (34, 68%). The most prevalent type of PFT was type III (20, 40%). Of the 40 patients with PFT, 34 (85%) also ex-hibited other dental anomalies such as tooth aplasia, peg-shaped incisors, talon cusps, ectopic eruption, and delayed eruption in both related and unrelated areas. The most common complications of PFT were fusion-related tooth aplasia (n = 26 [76%]) and caries formation in the affected teeth (24 [48%]).

CONCLUSION

In this study, PFT were frequently observed in the mandibular anterior region. Caries formation and dental anomalies, especially permanent tooth aplasia, were often encountered in areas where PFT were seen. Hence, parents should be informed about possible dental problems associated with PFT and be encouraged to schedule regular follow-up appointments.

A case of concrescent tooth-A developmental anomaly in a 19th century skull from Uganda

Dental abnormalities in archeological material such us concrescence or odontoma are rare cases often found accidentally, mostly during routine X-ray analysis or during macroscopic examination of the mastication apparatus. In this study, we present a rare case of concrescence between an upper left third molar and a supernumerary fourth molar in a 19th century skull from Uganda. Simultaneously, it is a critical revision of earlier studies on the same object (which considered this abnormality as an odontoma), using dental X-ray imaging and histological analysis. Concrescence is a rare dental anomaly and this specimen is, to the best of our knowledge, the first such case reported in paleopathological studies of Eastern Africa. It may contribute to recognition and identification of etiopathogenetic factors in dental developmental defects in historical and contemporary populations of Africa.

Prevalence of Dental Anomalies in Odisha Population: A Panoramic Radiographic Study

AIM

The aim of this study was to evaluate the prevalence of dental anomalies (DAs) in Odisha population using panoramic radiographs.

MATERIALS AND METHODS

In this study, 1,080 panoramic radiographs were evaluated for DAs. Dental records were reviewed for diagnostic confirmation. Anomalies related to the shape, size, position of teeth, and number of roots (supernumerary roots) were evaluated.

RESULTS

The study results showed the prevalence of DAs to be 35.27%. The most prevalent was dilaceration, which was seen in 46.71% cases followed by peg laterals in 20.99%.

CONCLUSION

Dental anomalies were present in more than one-third of the study group, which was mostly related to shape of the teeth. Early diagnosis of these DAs helps in avoiding complications.

CLINICAL SIGNIFICANCE

Identification of DAs requires proper examination and thereby subsequent correct diagnosis. These anomalies can pose complications in normal functioning of orofacial complex. The knowledge of the prevalence of such anomalies aids dental practitioners for a proper treatment plan.

A cross-sectional analysis of the prevalence of tooth agenesis and structural dental anomalies in association with cleft type in non-syndromic oral cleft patients

Background

The aim of this study was to investigate the prevalence of tooth agenesis, microdontia, and tooth malformation among non-syndromic oral cleft patients and their potential association with cleft type and gender.

Methods

Intraoral records and radiographs of 154 patients (97 males and 57 females) were examined. The variables assessed were tooth agenesis, microdontia, dental malformations, and cleft types. The statistics included chi-square and Fisher’s exact tests as well as logistic regression to assess any mutual effects of gender and cleft type on the dental variables.

Results

Tooth agenesis occurred in 50% of the sample and microdontia in 18%. Non-statistically significant odds ratios for the association of gender and cleft type with tooth agenesis were obtained. Tooth agenesis was substantially higher at the unilateral right CL + P and the bilateral CL + P in quadrant 1 and at the unilateral left CL + P and bilateral CL + P in quadrant 2. It was also higher, at the isolated cleft palate (CP) in quadrants 3 and 4. These results were attributed to teeth 22 (31.8%) and 12 (21.6%) in the maxilla and to teeth 35 (6.1%) and 45 (5.4%) in the mandible. In unilateral CL + P patients, the cleft quadrant that presented tooth agenesis was associated with the side of the cleft.

Conclusions

Interdisciplinary treatment of the oral cleft patients should take into consideration the high prevalence of tooth agenesis and their association with the different cleft types. The most frequently affected teeth by cleft are by far the upper lateral incisors. Results indicate that tooth agenesis appears to be a genetically controlled anomaly related to the orofacial cleft development through various genetic links and not caused by the cleft disruptive process.

Cleft palate with/without cleft lip in French children: radiographic evaluation of prevalence, location and coexistence of dental anomalies inside and outside cleft region

INTRODUCTION

Prevalence of dental anomalies in cleft patients is higher than that in general population. The objectives of this study were to assess the prevalence of dental anomalies and their coexistence in French children with cleft and, then, to investigate the relation between the dental anomalies and the cleft type.

MATERIAL AND METHODS

Seventy-four non-syndromic cleft patients (6-16 years old) from Lille Regional University and Mondor-Chenevier Hospitals (France) were included. Clefts were classified as right/left unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP) and cleft palate (CP). Dental anomalies were investigated on panoramic radiographs and categorized as agenesis, supernumerary teeth, incisor rotations, impacted canines and shape anomalies. Prevalence and gender distribution of dental anomalies, mean number of affected teeth per patient, agenesis occurrence and location, and coexistence of dental anomalies were analysed by cleft type.

RESULTS

96.0% of patients presented at least one dental anomaly (agenesis 83.8%, incisor rotations 25.7%, shape anomalies 21.6%, impacted canines 18.9%, supernumerary teeth 8.1%). BCLP patients had a higher number of affected teeth, and left UCLP patients had a higher one compared to right UCLP patients. Distribution of inside (45.3%) and outside (54.7%) cleft region agenesis was similar. Adjacent (31.8%) and not adjacent (33.3%) combined dental anomalies were often encountered.

CONCLUSIONS

Dental anomalies were localized inside as well as outside cleft region and were often associated with each other. BCLP patients were more affected.

CLINICAL RELEVANCE

Early radiographic evaluation allows a comprehensive diagnosis of inside and outside cleft region anomalies, required for the multidisciplinary dental treatment.

Teratogenicity of Antiepileptic Drugs

OBJECTIVE

Antiepileptic drugs (AED) have chronic teratogenic effects, the most common of which are congenital heart disease, cleft lip/palate, urogenital and neural tube defects. The aim of our study is to examine teratogenic effects of AED and the correlation between these malformations and AED in single or multiple pregnancies.

METHODS

This is a retrospective study of malformations in children born to mothers currently followed up by our outpatient clinics who used or discontinued AED during their pregnancy. Their children were then investigated using echocardiography, urinary ultrasound, cranial magnetic resonance image, and examined by geneticists and pediatric dentists.

RESULTS

One hundred and seventeen children were included in the study. Ninety one of these children were exposed to AED during pregnancy. The most commonly used AED were valproic acid and carbamazepine in monotherapy. The percentage of major anomaly was 6.8% in all children. Dysmorphic features and dental anomalies were observed more in children exposed especially to valproic acid. There were 26 mothers with two and four mothers with three pregnancies from the same fathers. No correlation was found between the distribution of malformations in recurring pregnancies and AED usage.

CONCLUSION

Our study has the highest number of dysmorphism examined in literature, found in all the children exposed to valproic acid, which may account for the higher rate of facial dysmorphism and dental anomalies. On lower doses of valproic acid, major malformations are not seen, although the risk increases with polytherapy. Our data also indicate possible effects of genetic and environmental factors on malformations.

Oral health status and treatment needs among 10126 school children in West Godavari district, Andhra Pradesh, India

Objectives:

Oral diseases are affecting a large percentage of children worldwide. This study with Indian Society of Pedodontics and Preventive Dentistry collaboration was taken up with the aim to evaluate the oral health status and treatment needs in school-going children of the West Godavari district, Andhra Pradesh, India.

Materials and Methods:

This cross-sectional study was conducted among 10126 school children who were randomly selected from 32 schools in West Godavari district. To find the significance of the obtained number of cases for different age groups, Chi-square test of significance was used.

Results:

The prevalence of dental conditions are as follows: Dental caries 63.5%, periodontal diseases 13.6%, dental anomalies 3.6%, dental trauma 3.2%, and orthodontic treatment 25.1%. Among the different age groups, 11–14 years age group has the highest prevalence of oral health problems. Females were more affected with dental caries (P = 0.17), orthodontic treatment needs (P = 0.12), and dental anomalies (P = 0.86) compared to males which was statistically insignificant. The highest prevalence of dental conditions in the case of females was observed during the age of 11–14 years, and in males, the peak was seen in the 15–18 years age group.

Conclusions:

This study demonstrated that school-going children in West Godavari district suffer from a high prevalence of dental conditions and have higher treatment needs.

pySAPC, a python package for sparse affinity propagation clustering: Application to odontogenesis whole genome time series gene-expression data

BACKGROUND

Developmental dental anomalies are common forms of congenital defects. The molecular mechanisms of dental anomalies are poorly understood. Systematic approaches such as clustering genes based on similar expression patterns could identify novel genes involved in dental anomalies and provide a framework for understanding molecular regulatory mechanisms of these genes during tooth development (odontogenesis).

METHODS

A python package (pySAPC) of sparse affinity propagation clustering algorithm for large datasets was developed. Whole genome pair-wise similarity was calculated based on expression pattern similarity based on 45 microarrays of several stages during odontogenesis.

RESULTS

pySAPC identified 743 gene clusters based on expression pattern similarity during mouse tooth development. Three clusters are significantly enriched for genes associated with dental anomalies (with FDR <0.1). The three clusters of genes have distinct expression patterns during odontogenesis.

CONCLUSIONS

Clustering genes based on similar expression profiles recovered several known regulatory relationships for genes involved in odontogenesis, as well as many novel genes that may be involved with the same genetic pathways as genes that have already been shown to contribute to dental defects.

GENERAL SIGNIFICANCE

By using sparse similarity matrix, pySAPC use much less memory and CPU time compared with the original affinity propagation program that uses a full similarity matrix. This python package will be useful for many applications where dataset(s) are too large to use full similarity matrix. This article is part of a Special Issue entitled "System Genetics" Guest Editor: Dr. Yudong Cai and Dr. Tao Huang.

Clinical evaluation of nonsyndromic dental anomalies in Dravidian population: A cluster sample analysis

AIM

To record the prevalence rate of dental anomalies in Dravidian population and analyze the percentage of individual anomalies in the population.

METHODOLOGY

A cluster sample analysis was done, where 244 subjects studying in a dental institution were all included and analyzed for occurrence of dental anomalies by clinical examination, excluding third molars from analysis.

RESULTS

31.55% of the study subjects had dental anomalies and shape anomalies were more prevalent (22.1%), followed by size (8.6%), number (3.2%) and position anomalies (0.4%). Retained deciduous was seen in 1.63%. Among the individual anomalies, Talon's cusp (TC) was seen predominantly (14.34%), followed by microdontia (6.6%) and supernumerary cusps (5.73%).

CONCLUSION

Prevalence rate of dental anomalies in the Dravidian population is 31.55% in the present study, exclusive of third molars. Shape anomalies are more common, and TC is the most commonly noted anomaly. Varying prevalence rate is reported in different geographical regions of the world.

The prevalence of dental anomalies in a turkish population

Purpose:

The aim of the present study was to investigate the prevalence of dental anomalies in a Turkish population according to the gender and age.

Materials and Methods:

A retrospective study was performed using panoramic radiographs of 2025 patients (885 males and 1140 females) ranging in age from 9 to 35 (mean age 25.61±10.04) years attending Department of Oral Radiology, University of Istanbul, Faculty of Dentistry. These patients were examined to determine the presence of developmental dental anomalies involving hypodontia, hyperdontia, microdontia, taurodontism and other root anomalies. The incidence of these anomalies were assessed according to the gender and age.

Results:

Among the 2025 subjects, a total of 96 individuals (42 males and 54 females) showed at least one of the selected dental anomalies (4.74%). Tooth agenesis was the most common dental abnormality (1.77%) followed by taurodontism (1.18%), hyperdontia (0.79%), microdontia (0.54%) and root anomalies (0.44%), respectively.

Conclusion:

Tooth agenesis is the most common developmental dental anomaly in the studied Turkish population followed by taurodontism.

Lobodontia: Genetic entity with specific pattern of dental dysmorphology

A characteristic pattern of dental anomalies including cone-shaped premolars, multitubercular molar crowns, pyramidal molar roots with single root canals, shovel-shaped incisors with palatal invaginations and hypodontia usually described as lobodontia was recognised as a separate entity. Only a few family reports on this condition have been published until now. The prevalence of the condition is estimated to be less than 1:1000,000. In the present paper we tried to delineate and clarify some additional aspects of this rare genetic entity in three families with 17 affected members. This represents the largest number of cases recorded since now. The analyses of dental morphology, crown-size profile patterns, pedigree analyses, and analyses of digitopalmar dermatoglyphics were performed in 7 examined patients. Crown-size profile pattern was calculated for seven patients and compared with standards for the Croatian population. The most striking features of the condition are conical premolars, tritubercular canines, single pyramidal molar roots, multitubercular molar crowns and invaginated upper incisors. A considerable reduction of crown-size was observed for all premolars, particularly in mandible. The alveolar process in the premolar region was hypoplastic and thin in all patients studied. Gender ratio of affected individuals was approximately M1:F1. Our data suggest that the prevalence of this condition is less than 1:300,000 in the Croatian population, which is considerably higher than previously reported in the literature. The analysis of the anomaly in all the families showed a slight variability in the clinical picture and autosomal dominant (AD) mode of inheritance. It could be concluded that this rare condition described as lobodontia represents a true genetic entity which follows AD mode of inheritance and displays variability in its expression.

Genetic background of supernumerary teeth

Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico–Rhino–Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed.

The prevalence of specific dental anomalies in a group of Saudi cleft lip and palate patients

Objective

The aims of this study were to investigate the prevalence and distribution of dental anomalies in a group of Saudi subjects with cleft lip and palate (CLP), to examine potential sex-based associations of these anomalies, and to compare dental anomalies in Saudi subjects with CLP with published data from other population groups.

Design

This retrospective study involved the examination of pre-treatment records obtained from three CLP centers in Riyadh, Saudi Arabia, in February and March 2010. The pre-treatment records of 184 subjects with cleft lip and palate were identified and included in this study. Pre-treatment maxillary occlusal radiographs of the cleft region, panoramic radiographs, and orthodontic study models of subjects with CLP were analyzed for dental anomalies.

Results

Orthopantomographs and occlusal radiographs may not be reliable for the accurate evaluation of root malformation anomalies. A total of 265 dental anomalies were observed in the 184 study subjects. Hypodontia was observed most commonly (66.8%), followed by microdontia (45.6%), intra-oral ectopic eruption (12.5%), supernumerary teeth (12.5%), intra-nasal ectopic eruption (3.2), and macrodontia (3.2%). No gender difference in the prevalence of these anomalies was observed.

Conclusions

Dental anomalies were common in Saudi subjects with CLP type. This will complicate the health care required for the CL/P subjects. This study was conducted to epidemiologically explore the prevalence of dental anomalies among Saudi Arabian subjects with CLP.