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...(AU)

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...(AU)

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.

Intervención educativa aplicada en niños de 5 a11 años portadores de hábitos deformantes bucales / Educational intervention applied in children from 5 to 11 years of age with deforming oral habits

Fundamento: Los hábitos son patronesneuromusculares de naturaleza compleja que se aprenden por su repetición frecuente, y sin serfuncionales ni necesarios hacen que actúen fuerzas no naturales sobre los dientes que pueden causar alteraciones dentomaxilofaciales. Objetivo: Evaluar la intervención de las medidas educativas aplicadas sobre los portadores de hábitos deformantes bucales en la escuela primaria Raúl Suárez Martínez del consejo popular Rafaelito. Método: se efectuó un estudiocuasiexperimental con intervención antes y después sin grupo de control en una muestra de 253 niños en el período comprendido de diciembre del 2006 a noviembre del 2007. Se procedió a aplicar el programa Para SonreírFeliz, con una frecuencia semanal. Se aplicaron entrevistas a los niños, padres y educadores después de las acciones educativas, para lograr la reducción de los hábitos deletéreos. Se analizaron variables como: edad y sexo, frecuencia de hábitos deformantes antes y después de aplicada la intervención a niños, educadores y padres. Resultados: Se elevó el nivel de conocimiento de los niños, padres y educadores de forma significativa, se eliminaron estos factores de riesgo en más del 50 por ciento de los niños, fueron los más frecuentes: la protracción lingual, succión del biberón y el tete, principalmente en el sexo femenino. Conclusiones: La intervención fue satisfactoria por la reducción de cada uno de los hábitos deformantes bucales encontrados, así como el elevadonivel de conocimiento adquirido con las consecuencias que producen; después de aplicada la intervención, se demostró que la labor educativa constituye unaherramienta fundamental para el Estomatólogo General Integral(AU)

Background: Habits are complex neuromuscular patterns learnt by frequent repetition and act as unnatural forces that may cause dental maxillofacial defects. Objective: To assess the intervention of educative measures applied to children with deforming buccal habits in the primary school Raúl Suárez Martínez from the zone Rafaelito. Methods: A cuasiexperimental study was developed, with before-after intervention without control group including 253 children from December 2006 to November 2007. We applied the program To Happily Smile with a weekly frequency. Surveys were applied to children, parents and teachers after the educational actions to achieve the reduction of incorrect habits. The studied variables were: age, sex,deforming habits frequency before and after the intervention. Results: The knowledge level of children, parents and teachers was significantly improved. Risk factors were eradicated in more than 50 percent of thechildren being the most frequent: lingual protraction, baby bottle suction, mainly among females. Conclusions:The intervention was successful for the reduction of deforming oral habits, and the high level of knowledge acquired. After the intervention it was shown that the educative process is a key tool for the General Comprehensive Dentist(AU)

Odontoma compuesto / Complex odontoma

El término odontoma ha sido aplicado a cualquier tumor originado en estructuras dentales o en las estructuras embrionarias de las cuales se desarrollan los dientes. Pueden presentarse como múltiples réplicas diminutas de dientes conocido como odontoma compuesto, o presentarse como aglomeraciones de tejido amorfo, y reciben el nombre de odontoma complejo. Es el tumor de tipo odontogénico que más se presenta. El caso clínico que se presenta es un niño de 12 años de edad que sus padres solicitan tratamiento de ortodoncia, pues refieren que el niño tiene los dientes en mala posición, al realizar placa periapical de diagnóstico se observa entre las raíz del incisivo lateral superior izquierdo y el canino, el hallazgo radiográfico. La lesión se aprecia como una zona radiolúcida bien definida en la que en su interior se ve una estructura radiopaca similar a un diente(AU)

The term odontoma has been applied to any tumor originated in dental structures or in the embryonic structures out of which the teeth are developed. They can appear as multiple tiny replicas of teeth known as compound odontoma, or as masses of amorphous tissue, which receive the name of complex odontoma. It is the most common tumor of odontogenic type. The clinical case that is presented is a 12 year-old boy whose parents request orthodontics treatment, because they refer that the boy has the teeth in bad position. On carrying out a diagnostic periapical x-ray ,it is observed among the root of the incisive lateral left superior and the canine. The lesion is observed as a well defined radiolucent area inside which a radioopaque structure similar to a tooth is seen(AU)

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

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.

Influencia del plan incremental a escolares en la epidemiología de las maloclusiones / Effect of the incremental program of students on the epidemiology of occlusions

Se realizó un estudio en las escuelas primarias, secundarias, preuniversitarios y la Escuela Especial del Municipio de Remedios, en la provincia Villa Clara en 109 estudiantes con el objetivo de determinar los porcentajes de anomalías de los dientes y la oclusión por nivel de escolaridad, sexo y procedencia en la población estudiada; así como demostrar la influencia del Programa Incremental de Escolares en la prevención de las maloclusiones(AU)

Lactancia materna en la prevención de anomalías dentomaxilofaciales / Breastfeeding in the prevention of dentomaxillofacial anomalies

Se realiza un análisis de la importancia de la lactancia materna para la prevención de las anomalías dentomaxilofaciales, además se exponen las ventajas del amamantamiento tanto para la salud bucal del niño como para su salud general, donde se explican algunas de las más importantes. Se relacionan también las ventajas que tiene para la madre la lactancia materna. Como conclusión se plantea que la alimentación al seno materno favorece el crecimiento y desarrollo del aparato masticatorio, evita la adquisición de hábitos deformantes bucales, mejora la oclusión dental en etapas posteriores del desarrollo infantil, previene las anomalías dentomaxilofaciales y contribuye a la prevención de las caries dentales(AU)