Supernumerary Teeth: A Retrospective Cross-Sectional Study from Palestine

Abstract Objective: To investigate the prevalence and characteristics of supernumerary teeth among patients attending the students' dental clinics at the Faculty of Dentistry of the Arab American University, Jenin, Palestine. Material and Methods: This is a descriptive, cross-sectional, retrospective study of 1970 digital panoramic radiographs of patients, age ranging between 12 and 50 years. The radiographs and dental records were reviewed for supernumerary teeth. For each patient with supernumerary teeth, were recorded the demographic variables, number, location, eruption status, type, and morphology, the developmental stages. Descriptive statistics were performed and results were tabulated. Results: Supernumerary teeth were detected in 17 subjects (0.86%), of which 13 were males and 4 were females with a male to female ratio of 3.25:1. Of the 17 patients, 64.7% had one supernumerary tooth while the others had two. The majority (78.3%) of the supernumeraries were located in the maxilla. Around 56.5% of the supernumeraries found in this study were located in the premaxilla. Half of the supernumeraries (52.2%) were erupted, and 47.8% were impacted. Mesiodens was the most frequently seen supernumerary teeth followed by distomolars and premolars. Most of the supernumeraries were fully developed, while 21.7% displayed only crown formation. Conclusion: The prevalence of supernumerary teeth in the study sample was found to be 0.86% and the most frequent type was mesiodens. Supplemental morphology was found to be the most common form of supernumerary teeth.

Reabilitação do incisivo central decíduo fusionado ao supranumerário: relato de caso clínico / Primary maxillary right central incisor fused to supernumerary: case report

diagnosticadas precocemente. Este trabalho teve como finalidade relatar o caso clínico de uma paciente de três anos, gênero feminino, cuja queixa principal era a estética dos dentes anteriores superiores,devido ao tamanho desproporcional de um elemento dentário, que se apresentava também com coloração alterada. Ao exame clínico e radiográfico diagnosticou-se uma anomalia denominada fusão dentária, união de dois dentes adjacentes, na região anteros superior. O tratamento consistiu na secção dos dois dentes e exodontia do supranumerário, seguida do tratamento restaurador do incisivo central direito que apresentava lesão de cárie. Concluiu-se que, por meio de adequado diagnóstico e planejamento, o tratamento proposto foi efetivo na reabilitação da função e da estética,assim como na prevenção de complicações clínicas e ortodônticas que poderiam advir da anomalia dentária descrita, caso não tratada. A autoestima da criança foi restabelecida.

Dental anomalies can cause serious disorders in the development of teeth if not diagnose dearly. This study aimed to report a case of a three-year-old patient, female, who together with her responsible, whose main complaint was the aesthetics of the upper front teeth due to disproportionatesize and altered staining. During the clinical and radiographic examinations, ananomaly called teeth merger, which is the union of two adjacent teeth, was diagnosed in the upper anterior region. The treatment included the sectioning of the two teeth and extraction of the super numerary, followed by restorative treatment of the right central incisor that had caries lesions. It was concluded that, through proper diagnosis and planning, the proposed treatment was effective in the rehabilitation of function and aesthetics, as well as in the prevention of clinical and orthodontic complications that could result from the dental anomaly described, ifuntreated. The child’s self-esteem was re-established.

Current understanding of the process of tooth formation: transfer from the laboratory to the clinic.

Teeth are typical examples of organs in which genes determine the progress of development from initiation to the final shape, size and structure, whereas environmental factors play a minor role. Advances in gene technology over the last three decades have led to powerful novel methods to explore the mechanisms of embryonic development. Today we know a few hundred genes that regulate tooth development, and mutations in dozens of these genes have been shown to cause aberrations in tooth development in mice and/or humans. The functions of an increasing number of genes in tooth development have been discovered using genetically modified mouse models. We are now beginning to understand the 'programme' underlying the process of tooth formation. Key components of the programme are signals mediating communication between cells and complex gene regulatory networks in which the signal pathways are integrated. Understanding the mechanisms of tooth development at the level of genes, cells and molecules will lay the basis for new ways to prevent and treat dental defects and diseases. Over the last decade knowledge about dental stem cells has accumulated rapidly and novel stem cell technologies have been developed. Combining stem cell research with knowledge on the mechanisms of tooth development may open up novel possibilities for clinical tooth regeneration.

[Spontaneous dental abscesses in familial hypophosphatemic rickets]. / Multipele spontane odontogene abcessen bij familiaire hypofosfatemische rachitis.

Symptoms of familial hypophosphatemic rickets are growth retardation, the formation of O- or X-legs, pain of the joints, spontaneous dental abscesses, and delayed tooth eruption. The dental symptoms are predominantly attributable to the demineralization of dentin. In absence of adequate preventive measurements,familial hypophosphatemic rickets may lead to spontaneous pulpal necrosis. The prophylactic application of occlusal sealants might be effective in preventing abscess formation.

[Radiation-related caries: etiology and possible preventive strategies. What should the radiotherapist know?]. / Radiogene Karies: Ätiologie und Möglichkeiten der Prävention. Was sollte der Strahlentherapeut wissen?

BACKGROUND: After radiation treatment of head-and-neck cancer, the impairment of patient's quality of life still remains an issue. After completion of the treatment course, a substantial number of patients develop so-called radiation caries. In addition, almost 50% of all cases of infectious osteoradionecrosis (iORN) of the jaws are directly associated with radiation caries. This review addresses our current knowledge on the etiology and pathogenesis of radiation caries including possible preventive strategies. MATERIALS AND METHODS: A PubMed search using the terms "radiation caries" ("radiation related caries", "radiation related damage to dentition") and "radiogenic caries" ("postradiation caries", "dental complications and radiotherapy") was performed. The analysis of its content focused on the etiology, the pathogenesis, and the available knowledge on prophylaxis as well as treatment of radiation caries. RESULTS: For this review, 60 publications were selected. As main causal factors for radiogenic caries, either indirect impairment, resulting from alterations in the oral environment (e.g., radiation-induced xerostomia) or direct radiation-induced damage in teeth hard tissues are discussed. Radiation caries remains a lifelong threat and, therefore, requires permanent prevention programs. CONCLUSION: To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential.

Enzyme replacement therapy prevents dental defects in a model of hypophosphatasia.

Hypophosphatasia (HPP) occurs from loss-of-function mutation in the tissue-non-specific alkaline phosphatase (TNALP) gene, resulting in extracellular pyrophosphate accumulation that inhibits skeletal and dental mineralization. TNALP-null mice (Akp2(-/-)) phenocopy human infantile hypophosphatasia; they develop rickets at 1 week of age, and die before being weaned, having severe skeletal and dental hypomineralization and episodes of apnea and vitamin B(6)-responsive seizures. Delay and defects in dentin mineralization, together with a deficiency in acellular cementum, are characteristic. We report the prevention of these dental abnormalities in Akp2(-/-) mice receiving treatment from birth with daily injections of a mineral-targeting, human TNALP (sALP-FcD(10)). sALP-FcD(10) prevented hypomineralization of alveolar bone, dentin, and cementum as assessed by micro-computed tomography and histology. Osteopontin--a marker of acellular cementum--was immuno-localized along root surfaces, confirming that acellular cementum, typically missing or reduced in Akp2(-/-) mice, formed normally. Our findings provide insight concerning how acellular cementum is formed on tooth surfaces to effect periodontal ligament attachment to retain teeth in their osseous alveolar sockets. Furthermore, they provide evidence that this enzyme-replacement therapy, applied early in post-natal life--where the majority of tooth root development occurs, including acellular cementum formation--could prevent the accelerated tooth loss seen in individuals with HPP.

Interferencias oclusales y su relación con las maloclusiones funcionales en niños con dentición mixta / Occlusal interferences and its relation with functional malocclusions in children with mixed dentition

Las interferencias oclusales son un problema frecuente en la dentición temporal y mixta, están asociadas a maloclusiones funcionales como mordidas cruzadas anteriores, mordidas cruzadas posteriores, así como anomalías faciales y afectaciones de la articulación temporomandibular. Se realizó un estudio observacional descriptivo de corte transversal, donde fueron examinados 820 niños pertenecientes a escuelas primarias, área de salud Contreras, del municipio de Matanzas, con la finalidad de identificar las interferencias oclusales que se relacionaron con la presencia de mordida cruzada anterior funcional, mordida cruzada posterior unilateral funcional. Del total de niños examinados, 138 presentaron interferencias oclusales, de ellos el 36,9 por ciento presentó mordida cruzada anterior, y un 63,0 por ciento mordida cruzada posterior. La detección precoz de las interferencias oclusales nos dará la posibilidad de la intercepción de maloclusiones dentarias, así como en la prevención de anomalías dentomaxilofaciales y alteraciones de la articulación tempomandibular.

The occlusal interferences are a frequent problem in temporal and mixed dentition. They are associated to functional malocclusions with anterior crossed biting, posterior crossed biting, and also to facial anomalies and affections of the temporomandibular articulation. We carried out a descriptive, observational, transversal study, where we examined 820 primary school children of the Contreras health area, municipality of Matanzas, to identify the occlusal interferences related to the presence of functional anterior crossed biting, functional unilateral posterior crossed biting. 138 of the examined children presented occlusal interferences; 36,9 percent of them presented anterior crossed biting, and 63,0 percent posterior crossed biting. The precocious detection of occlusal interferences will give us the possibility of intercepting dental malocclusions and also of preventing dentomaxillofacial anomalies and alterations of the temporomandibular articulation.

Evaluación del impacto del taller sobre lactancia materna y su rol preventivo en las anomalías dentomaxilofaciales: 2003 / Assessment of the impact of the Braest Feeding and its preventive role in tooh and jaw abnormalities workshop: 2003

A fin de evaluar el impacto del taller de capacitación integral para gestantes sobre la lactancia materna en la prevención de las anomalías dentomaxilofaciales, se realizó un estudio prospectivo y descriptivo en 42 gestantes ingresadas en el bloque ginecoobstétrico del Hospital Provincial Abel Santamaría, en el período comprendido del 1ro. de enero al 31 de marzo de 2003. Los datos se recogieron en un formulario que incluía un examen diseñado al efecto, con el objetivo de evaluar el grado de conocimiento que poseían las gestantes en relación con la importancia de la lactancia materna en la prevención de anomalías dentomaxilofaciales. Las variables analizadas fueron: edad, ocupación, procedencia y resultados de la calificación del examen. Una vez aplicado el examen, se impartió un taller acerca de este tema y posteriormente se les reaplicó a las gestantes el mismo examen. Se obtuvo que el nivel de conocimiento de las gestantes sobre la importancia de la lactancia materna y la función masticatoria en el desarrollo del sistema estomatognático fue inadecuado en los distintos grupos de edad y variables bio-psico-sociales estudiadas, antes de la capacitación. Las temáticas que mayor dificultad tuvieron fueron las relacionadas con el desarrollo adecuado de la mandíbula, la respiración nasal y la deglución. Se concluye que el taller de capacitación impartido a las gestantes tuvo un gran impacto, pues se logró que adquirieran los conocimientos básicos en el amamantamiento natural e introducción de la alimentación sólida y sobre la lactancia materna en la prevención de las anomalías dentomaxilofaciales(AU)

With the objective of assessing the impact of comprehensive training workshop on the role of breast-feeding in the prevention of tooth and jaw abnormalities aimed at pregnant women, a prospective descriptive study of 42 pregnant women, who were admitted to the gynecological-obstetric area of "Abel Santamaría" provincial hospital from January 1st to March 31st, 2003 was conducted. Data were collected into a form that included a test to evaluate the level of knowledge of these women about the importance of breast-feeding in the prevention of tooth and jaw abnormalities. Analytical variables were age, job, origin and test marks. Once the test was applied, participating pregnant women were given a workshop on this topic and later, they made the test again. Before the training course, their level of knowledge on the significance of breast-feeding and the masticatory function on the development of the stomatognatic system was poor at the various age groups and biological and psycho-social variables studied. The most difficult topics were those related with jaw, nasal respiration and deglutition development. It was concluded that the training workshop for pregnant women had a great impact since it succeeded in conveying basic pieces of knowledge about natural feeding and the introduction of solid feeding in addition to the role of breast-feeding in the prevention of tooth and jaw abnormalities(AU)

Dental abnormalities in patients with familial hypophosphatemic vitamin D-resistant rickets: prevention by early treatment with 1-hydroxyvitamin D.

OBJECTIVE: To evaluate the dental effects of 1-hydroxylated vitamin D3 treatment in patients with familial hypophosphatemic vitamin D-resistant rickets. Study design Forty-eight children and adult patients were included in the study; 16 had received no treatment or phosphate supplements with vitamin D/25-(OH) D3 before puberty. The 32 younger ones had received phosphate supplements with 1alpha-(OH)D3 from infancy. All patients were clinically examined, and panoramic and periapical radiographs were made. Evaluations of decayed, missing, or filled teeth and decayed or filled teeth indexes and of pulp ratios allowed comparison with healthy age-matched control patients. RESULTS: Poor dental health and characteristic dental anomalies were found in the 16 older patients. In contrast, the 32 younger patients had a normal dental status as regards reference ranges in healthy age-matched populations, although they still showed prominent pulp horns on deciduous teeth and increased pulp area/tooth area ratios. CONCLUSIONS: This investigation shows the beneficial effects of 1alpha-(OH)D3 treatment on the dental status of vitamin D-resistant rickets patients and emphasizes the necessity of early treatment. Remaining defects may result from early exposure of odontoblasts and surrounding osteoblasts to hypophosphatemia, before the commencement of treatment, and/or from intrinsic cell disturbances linked to the genetic alteration(s).

[Exchange of dentition and its control. Overview of current knowledge and personal experience]. / Výmena denticí a moznosti jejího rízení. Prehled soucasných poznatku a vlastních zkuseností.

Physiological dentition exchange is often interfered with exogenous and endogenous factors. For this reason it must be steadily regulated. The authors present complex view on this topic based on literature studies and own experiences. The authors define fundamental principles "guided exchange", "tooth eruption" and "eruption path". Correct explication of these ideas is necessary for text understanding. Dentition exchange is considered as complex of eruption interactions of individual permanent teeth including molars. The project is based on idea that dentition exchange time is optimal for preventive interventions. At the end the authors underline the importance of global application of the above-mentioned principles on the whole child population.

[The problems in studying the prevalence and the organization of the prevention of maxillodental anomalies in children]. / Problemy izucheniia rasprostranennosti i organizatsii profilaktiki zubocheliustnykh anomalii u detei.

Methodological aspects of studies of the prevalence and organization of prevention of maxillodental abnormalities in children are discussed, effects of a number of factors on the incidence of such abnormalities shown. The author emphasizes that prevention of abnormalities should start in early age and be based on an individual approach to a child. A conclusion is made on the necessity of development of a unified program of epidemiological study of abnormalities in the country.

Comparison of electrosurgery with conventional fiberotomies on rotational relapse and gingival tissue in the dog.

The relapse tendency of orthodontically rotated teeth after electrosurgical circumferential fiberotomies and after conventional scalpel blade surgical procedures was demonstrated with a split-mouth procedure involving the maxillary second incisors of five mongrel dogs. The second incisors were rotated orthodontically an average of 63.5 degrees over a 4-month period. Electrosurgical circumferential fiberotomies were performed on the designated second incisors, and circumferential fiberotomies with a scalpel blade were performed on the contralateral incisors. The teeth were retained for 1 month and relapse was measured 2 months postretention. Wound healing was demonstrated by measurement of sulcus depths and facial gingival recession preoperatively and at 1, 2, 3, 4, and 9 weeks after surgery. In both groups, the sulcus depths had decreased about 2 mm and the facial gingiva had receded 0.3 mm 9 weeks after surgery. Two months postretention there was an average 25% relapse in the teeth treated by means of a circumferential fiberotomy with a scalpel blade compared to an average 23% relapse in those treated by means of a circumferential fiberotomy with electrosurgery. No significant difference was seen between the two techniques.

Programa de prevención de anomalías dentomaxilofaciales en la facultad de odontología-Universidad Javeriana / Prevention program of dentomaxillofacial anomalies at the Faculty of Denistry of the Javeriana's University

La Universidad Javeriana y la Facultad de Odontología como centro de enseñana superior tienen el objetivo de prestar un servicio docente-asistencial a nuestra comunidad en el área de la salud cada vez mejor, más organizado y eficiente. Así se concibió la idea de desarrollar un programa de prevención de anomalías dentomaxilofaciales (ADMF) con asesoría genética; y la propuesta de organización del mismo fue el trabajo de grado para optar por el título de especialista en ortodoncia.