Radiological features and treatment of erupting maxillary canines in relation to the occurrence of dental developmental abnormalities.

OBJECTIVE: This study aimed to investigate the radiological features of the permanent canines and the treatment carried out to ensure their eruption relative to certain features involved in Dental Anomaly Patterns (DAP). MATERIAL AND METHODS: The cross-sectional part of this retrospective register--based study focused on 1,315 dental panoramic tomographs (DPTs) of children aged 8.5-10.5 years, while the longitudinal part involved information on the treatment provided for 1,269 canines after the DPTs and on their eruption into the oral cavity. RESULTS: The canines of the DAP children more often showed evidence of early treatment (p = 0.014), with girls having more frequently interceptive treatment (p = 0.004) and boys early headgear (p = 0.022). Delayed dental age was associated with early treatment (OR 3.29, 95% CI 1.08-9.99). Either no or clear overlapping of a canine with the lateral incisor occurred more often in the DAP children, whereas canine inclination did not differ between the groups. The root development stage of the canine was more often either beginning or well advanced in the DAP children. CONCLUSIONS: The children with dental developmental abnormalities more often showed evidence of early treatment for the canines. Monitoring of the erupting canines after the first mixed stage is important to enable timely early treatment.

Developmental and Acquired Abnormalities of the Teeth.

This review aims to present a detailed analysis of the most common developmental and acquired dental abnormalities, including caries, resorptive lesions, and congenital anomalies of teeth number, size, form, and structure. This review highlights how diagnostic imaging can aid in the accurate identification and management of these conditions.

Peripheral odontogenic fibroma in a child with Ellis-van Creveld syndrome: Case report.

INTRODUCTION: Ellis-van Creveld (EVC) syndrome is an autosomal recessive disorder predominantly characterized by a disproportionate dwarfism, ectodermal dysplasia, postaxial polydactyly, and congenital heart malformations and pulmonary hypoplasia. OBJECTIVE: In this article, we hereby present a case of a 6-year-old Brazilian boy with EVC syndrome who presented a rare oral lesion as well as a remarkable number of classical and uncommon oral and dental features. CASE REPORT: Clinical and radiographic examination revealed multiple enamel hypoplasia, teeth agenesis, conical teeth, lower canine rotation, bilateral posterior crossbite, taurodontism of deciduous and permanent molars and delayed tooth eruption, dental caries, and absent vestibular sulcus. Additionally, a whitish lobulated nodule located in the alveolar ridge in the anterior region of the mandible was noted. Anatomopathological examination was compatible with the diagnosis of peripheral odontogenic fibroma (POF). In a 10-month clinical follow-up, no signs of recurrence were observed. CONCLUSION: In view of the characteristic oral findings of EVC syndrome and the potential for recurrence of POF, the pediatric dentist plays an essential role in clinical follow-up, planning and preventive, and rehabilitative treatment.

Prescription of panoramic radiographs in children using age-based prevalence of dental anomalies and pathologies.

BACKGROUND: Panoramic radiographs (PRs) are used in the detection and diagnosis of developmental dental anomalies and pathologies (DDAPs) in children. AIM: The primary objective of this observational cohort study was to evaluate the age-based prevalence of DDAP on PRs, whereas the secondary objective was to determine a threshold age for the detection of DDAP to provide supportive evidence for the prescription of PR in paediatric dental practice. DESIGN: The study examined diagnostic PRs from 581 subjects aged 6 to 19 years. All PRs were reviewed by experienced, calibrated, masked examiners for the identification or presence of anomalies in size, shape, position, structure, and other developmental anomalies and pathologies (ODAP) of the face-neck region in a standardized condition. The data were statistically analyzed for interpretation. RESULTS: Overall, 74% (n = 411) of the cohort had at least one anomaly (shape anomaly: 12%, number anomaly: 17%, positional anomaly: 28%, structural anomaly: 0%, and ODAP: 63%). The optimal Youden index cutoff for any anomaly was 9 years. Twelve and 15 years also showed predictive ability. CONCLUSION: The results suggest that PRs should be prescribed at ages 9, 12, and 15 years for the diagnosis of DDAP.

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits.

INTRODUCTION: Despite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns. METHODS: This epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05). RESULTS: Prevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables 'sagittal skeletal relationships, vertical growth patterns, PP, and APAD' showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities. CONCLUSIONS: STB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

Is there an association between molar incisor hypomineralization and developmental dental anomalies? A case-control study.

BACKGROUND: The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies. METHODS: Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies. RESULTS: No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively). CONCLUSIONS: While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.

Deep phenotyping of the neuroimaging and skeletal features in KBG syndrome: a study of 53 patients and review of the literature.

BACKGROUND: KBG syndrome is caused by haploinsufficiency of ANKRD11 and is characterised by macrodontia of upper central incisors, distinctive facial features, short stature, skeletal anomalies, developmental delay, brain malformations and seizures. The central nervous system (CNS) and skeletal features remain poorly defined. METHODS: CNS and/or skeletal imaging were collected from molecularly confirmed individuals with KBG syndrome through an international network. We evaluated the original imaging and compared our results with data in the literature. RESULTS: We identified 53 individuals, 44 with CNS and 40 with skeletal imaging. Common CNS findings included incomplete hippocampal inversion and posterior fossa malformations; these were significantly more common than previously reported (63.4% and 65.9% vs 1.1% and 24.7%, respectively). Additional features included patulous internal auditory canal, never described before in KBG syndrome, and the recurrence of ventriculomegaly, encephalic cysts, empty sella and low-lying conus medullaris. We found no correlation between these structural anomalies and epilepsy or intellectual disability. Prevalent skeletal findings comprised abnormalities of the spine including scoliosis, coccygeal anomalies and cervical ribs. Hand X-rays revealed frequent abnormalities of carpal bone morphology and maturation, including a greater delay in ossification compared with metacarpal/phalanx bones. CONCLUSION: This cohort enabled us to describe the prevalence of very heterogeneous neuroradiological and skeletal anomalies in KBG syndrome. Knowledge of the spectrum of such anomalies will aid diagnostic accuracy, improve patient care and provide a reference for future research on the effects of ANKRD11 variants in skeletal and brain development.

Association between maxillary canine impaction and other dental anomalies: radiological study of a mixed dentition children's cohort from an orthodontic clinic.

PURPOSE: To investigate the significance of association between maxillary impacted canines and various dental anomalies. METHODS: Files of 874 orthodontic patients were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least 1 impacted maxillary canine consisted the study group. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs. Chi-square test was used to perform the analysis for significant associations. Stepwise discriminant analysis, binary logistic regression and classification tree were used to identify best combinations. RESULTS: Statistically significant difference was found for peg-shaped maxillary lateral incisors and infraoccluded deciduous molars. The presence of peg-shaped upper lateral incisors arises the probability of impacted canine to 83.3%, a distal displaced unerupted second premolar to 63.16% and the impaction of any other teeth to 80% as showed by the classification tree. CONCLUSIONS: The presence of peg-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered major valuable early risk indicators for maxillary canine impaction, because they manifest before the maxillary canine eruption. Special consideration should be given on distal displaced unerupted second premolar and the impaction of any other teeth. Patients with these dental anomalies are candidates for future interceptive treatment for canine eruption.

Prevalence and morphological features of molar-root incisor malformation in children attending a specialist paediatric dental unit.

BACKGROUND: Molar-root incisor malformation (MRIM) is a rare dental anomaly featuring constricted cervical margins and tapered, narrow root and pulp morphology, often associated with severe toothache and infection. AIM: The aim of this study was to determine the prevalence of MRIM in children seen in a specialist paediatric dental unit of a tertiary referral hospital and to describe the characteristics of affected individuals. DESIGN: This study was an audit of children attending from November 2020 to November 2021. Radiographs were used to identify individuals with MRIM, and clinical data were collated. In addition, histology and microcomputed tomography (microCT) imaging were performed on teeth extracted from an affected individual. RESULTS: The prevalence of MRIM was five cases of 1054 children examined (0.47% or 1:210). The permanent first molars were affected in all five children and the primary second molars in two children; all children had medical comorbidities and multiple exposures to general anesthesia before 4 years of age. In addition, histological and microCT analyses displayed numerous microchannels connecting the pulp chamber to the external surface of the tooth at the furcation. CONCLUSIONS: Molar-root incisor malformation is an uncommon dental anomaly affecting paediatric patients with multiple comorbidities and is characterized by porosities extending from the pulp chamber to the external tooth surface, predisposing the risk of bacterial ingress from the oral cavity into the pulp chamber. Early detection may prevent atypical odontogenic facial pain and infection.

The prevalence of developmental dental and eruption anomalies assessed using panoramic radiographs: a retrospective study.

Developmental dental anomalies are a common finding in adolescent populations. The objective of this study was to utilize panoramic radiographs to determine the prevalence of dental anomalies and developmental disturbances in a heterogenous adolescent orthodontic patient population seeking care at a North American orthodontic residency program. A total of 1042 panoramic radiographs of 457 male and 585 female orthodontic patients aged 10 to 18 years were evaluated. Developmental and eruption anomalies were recorded and categorized, and chi-square and Fisher exact tests were used for statistical analysis. The evaluation revealed that 40.88% of patients had at least 1 anomalous finding. The most common finding overall was agenesis (12.00%), followed by deviations in eruption path (9.12%), delayed eruption (7.39%), and impaction (7.29%). There was no difference in the prevalence of having any anomalous finding or the prevalence of any specific category of anomalies based on the sex or Angle classification of the patients. Comparison of developmental dental anomalies in 3 age groups (10 to 12, 13 to 15, or 16 to 18 years) revealed no statistically significant difference in the overall prevalence of anomalous findings. Statistically significant differences for some specific categories of anomalies were explainable by correlating dental development with chronologic age, such as a greater frequency of blocked out teeth and eruption path deviation among patients aged 10 to 12 years. Black patients were found to have a significantly greater prevalence of impactions (P = 0.030), and Asian patients had a significantly greater prevalence of anomalies categorized as "other pathology," which could not be definitively diagnosed by panoramic radiograph alone (P = 0.007).

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.

Association between dental agenesis and delay in dental development: a preliminary study in a Spanish paediatric population in relation with Dental Anomaly Pattern (DAP).

BACKGROUND: The association between dental anomalies has been studied, giving rise to the concept of Dental Anomaly Pattern (DAP). Tooth agenesis has been associated with alterations such as molar infracclusion, taurodontism and delayed dental development. The aim of this study was to evaluate the dental development pattern in patients with non-syndromic dental agenesis, in comparison with a control group. METHODS: Dental and chronological age was analysed in a sample size of 204 orthopantomographs divided into a study group (n = 104) and a control group (n = 100) with the Demirjian Method. Intra and intergroup differences in chronological and dental age, and the correlation between them were calculated by statistical analysis with a 95% confidence level (p < 0.05). RESULTS: Dental age exceeded chronological age both in the control group and in the study group. Statistically significant differences (p = 0.004) were found when comparing the difference between chronological and dental age in the study (-0.16 ± 1.12) and control group (-0.58 ± 0.90). Regarding sex and age intergroup differences, the results were only statistically significant in the girls' group (p = 0.017), and the age over 8 years old (p < 0.05). There were no significant differences in tooth development depending on the number of missing teeth or the affected tooth group, but there was a delay in the development of the homologous tooth contralateral to the absent one in 14.9% of patients. CONCLUSIONS: The difference between chronological and dental age in permanent dentition is significantly lower in Spanish children with non-syndromic agenesis compared to a control group, presenting a lower dental age than chronological age than children without non-syndromic agenesis.

Mandibular talon cusp: a rare dental anomaly.

Talon cusp is a rare dental anomaly which consists of a supernumerary projection from the cingulum towards the incisal edge of the tooth. The cusp is made up of enamel and dentin but pulpal tissue may or may not be present. The occurrence of mandibular talon cusp is a rare entity with only 58 cases reported until now. This article reports a case of talon cusp on a mandibular central incisor along with a literature review of all mandibular talon cusp reported in history.

Prevalence of Dental Anomalies Assessed Using Panoramic Radiographs in a Sample of the Turkish Population.

OBJECTIVE: To determine the prevalence, frequency and distribution of dental anomalies that were detectable on panoramic radiographs in a large sample Turkish population, and the associations among the anomalies. METHODS: This study was conducted retrospectively on panoramic radiographs of 43,880 patients who were admitted to the Faculty of Dentistry at Trakya University, Edirne, Turkey. Patients' files were examined by two observers and radiographic images of 2265 patients with at least one dental anomaly were included. Dental anomalies were classified as anomalies in the number, structure, position and shape of teeth. The interactions between the groups were analysed using chi-square tests. RESULTS: The study group consisted of 1336 women (59%) and 929 men (41%) with a mean age of 33.3 ± 14.4 years. A total of 2265 patients, with a prevalence of 5.2% (2265/43880), had at least one dental anomaly. The most frequent anomalies were in position (2.7%) and number (2.1%). Structure anomalies were least common, affecting 0.02% of patients. Among the study group of patients with dental anomalies, 12.2% presented more than one kind of anomaly. CONCLUSION: Position anomalies were the most common dental anomaly, whereas structural anomalies were least common in a Turkish sample. The prevalence of anomalies varies between populations, confirming the role of racial factors.

[Clinical radiological evaluation of teeth-part 1 : Anatomy and anomalies]. / Klinisch-radiologische Beurteilung der Zähne ­Teil 1 : Anatomie und Anomalien.

Radiological assessment of the teeth and periodontium is often left to the dentist. Nevertheless, it is useful to know the anatomy and possible anomalies of the teeth in order to correctly assess pathological processes in both projection radiographic and slice imaging. Dental radiological examinations, such as panoramic slice imaging (PSA) and dental film are used for targeted diagnostics. In the case of incidental findings, a dental presentation should be made for further clarification. This article first provides an overview of the anatomy and anomalies of teeth.

Duration and dose of chemotherapy and dental development.

BACKGROUND: Given the susceptibility of developing tissues to drugs, even small doses of anticancer drugs may affect odontogenesis. Although any toxic effect is transient, the treatment regimens are based on repeated drug administration. OBJECTIVES: The study aimed to establish the impact of antineoplastic therapy on the occurrence of longterm adverse dental effects in a dose-dependent manner in young survivors treated for cancer before 10 years of age. MATERIAL AND METHODS: In total, 37 cancer survivors treated with antineoplastic therapy before 10 years of age underwent a dental examination with a thorough analysis of panoramic radiographs. A total of 236 teeth with 243 different developmental abnormalities were revealed in 28 survivors. Agenesis, tooth size reduction, taurodontia, and enamel and root abnormalities were diagnosed. All survivors received multi-agent chemotherapy, with the most frequently used drugs being vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), ifosfamide (IF), etoposide (VP-16), carboplatin (CBDCA), cisplatin (CDDP), and actinomycin-D (ActD). A detailed analysis of medical records was also performed to assess the relationship between the treatment duration as well as the cumulative drug dose administered and the occurrence of particular disturbances. RESULTS: When analyzing the treatment duration and the drug doses in the affected and non-affected participants, there were no statistically significant differences between the survivors with different disturbances within most of the specific drug groups. In some groups, the mean cumulative treatment dose was significantly higher in the non-affected patients. According to Spearman's rho, no significant relationships were observed. CONCLUSIONS: In the present study, no significant differences in terms of treatment duration or drug doses were observed between the patients with particular abnormalities. The developmental stage of tooth formation during chemotherapy is likely the most important factor influencing dental changes. For future research with respect to different treatment protocols, an analysis of a more homogenous group of survivors is warranted.

Otodental syndrome: Case report and differential diagnosis with Treacher Collins syndrome.

BACKGROUND: Otodental syndrome and Treacher Collins syndrome are rare diseases that have similar clinical features, which can complicate the diagnostic process. These syndromes cause skeletal and dental abnormalities, the differential diagnosis can be based on clinical signs but only the genetic analysis can confirm it. The aim of this case report is to describe and compare clinical signs of these syndromes. CASE REPORT: A 7-year-old patient came to our department: he presented abnormal tooth shapes and sizes, delayed teeth replacement and micrognathia. After extra- and intra-oral examination and radiographic exams, a clinical diagnosis of otodental syndrome was made, and a genetic testing was requested to confirm the diagnosis. CONCLUSION: Dental management of patients with otodental syndrome is challenging due to agenesis, teeth malformation, lack of space for permanent dentition. Proper treatment decision is crucial to obtain the best result for the patient.

Diagnóstico por imágenes de un odontoma complejo. Presentación de un caso / Diagnostic imaging of a complex odontoma. A case report

RESUMEN Los odontomas son los tumores más frecuentes del área bucal y maxilofacial. Presentamos un caso clínico de una paciente femenina de 50 años, con cuadros de sinusitis a repetición y dolor en región maxilar derecha. Se le realiza tomografía axial computarizada simple de macizo facial, donde se observó una imagen amorfa de densidad variable a nivel del hueso maxilar derecho, que involucraba la porción inferior del seno, compatible con tumor odontogénico, probablemente benigno, sugestiva de un odontoma complejo.

ABSTRACT Odontomas are the most common tumours located in the oral and maxillofacial region. We present a 50-year-old female patient with recurrent sinusitis and pain in the right maxillary region. A simple computed axial tomography of the facial mass was performed, where an amorphous image of variable density was observed at the level of the right maxillary bone, involving the lower portion of the sinus, compatible with an odontogenic tumour, probably benign and suggestive of a complex odontoma.

Skeletal-dental features in 33 bull terrier dogs.

BACKGROUND: The Bull terrier breed has been reported in the veterinary literature to suffer frequent dental and skeletal malocclusions. In this retrospective case series, we report skeletal-dental anomalies in a group of 33 Bull terriers presented for a dental consultation. RESULTS: Out of 33 dogs examined, 24 cases had full mouth radiography or Cone-beam computed tomography performed. Eruption and development abnormalities observed were as follows: hypodontia in 54.1% (13/24), eruption changes in 29.2% (7/24), and tooth shape abnormalities in 33.3% (8/24). All dogs presented with some type of dental or skeletal malocclusion: neutroclusion was the most common (66.7% of the animals), followed by mandibular mesioclusion (18.8%), maxillo-mandibular asymmetry (9.4%), and mandibular distoclusion (6.3%). Dental abnormalities noted included rotation of mandibular and maxillary premolar teeth, distal displacement of the incisor teeth, lingual displacement of the mandibular canine teeth, and absence of mandibular premolar and molar teeth. Lingual displacement of mandibular canine teeth was associated with malocclusion causing trauma (odds ratio 7.1, 95% confidence interval [1.4 to 36.1], p = 0.024). CONCLUSIONS: Malocclusions and tooth shape abnormalities were found to be the most frequent finding in this group of Bull terriers. Although these findings cannot be generalized to the global population further studies are needed to observe the true expression of these anomalies in the general breed population.