Delayed Eruption of Permanent Lower Lateral Incisor in Relation to Compound Odontoma: A Case Report.

AIM: To report a delayed tooth eruption following late surgical removal of a compound odontoma in a 10-year-old child. BACKGROUND: Odontomas are the most common odontogenic tumors. They are usually asymptomatic and discovered during routine radiographic examinations or during an assessment of delayed tooth eruption. Odontomas are classified into compound or complex based on the microscopic structure of dental tissues. Early diagnosis and surgical removal of odontomas is the keyword for favorable results. CASE DESCRIPTION: This paper describes a case of compound odontomas in a 10-year-old boy that prevented eruption of the permanent mandibular lateral incisor. Extraction of mandibular primary lateral incisors and surgical excision of the compound odontomas was performed. After 3 years of follow-up, at the age of 13 years, the permanent lateral incisor erupted and approached the occlusal plane. CONCLUSION: Late surgical removal of odontomas resulted in a delayed eruption of the affected teeth. CLINICAL SIGNIFICANCE: Surgical removal of odontomas and regular follow-up to monitor the eruption of the affected teeth should be considered for the teeth with an open apex before considering orthodontic traction.

Tooth formation and eruption - lessons learnt from cleidocranial dysplasia.

The principles of formation, renewal, and eruption of teeth are discussed. Numerous genetic aberrations may affect the formation and eruption of teeth. Cleidocranial dysplasia (CCD), caused by mutations in the runt-related transcription factor 2 (RUNX2) gene, is such a condition. The dental phenotype includes problems in both tooth formation (multiple supernumerary permanent teeth) and tooth eruption (lack of shedding of primary teeth and delayed or arrested eruption of permanent teeth). Clinical studies, animal models, and molecular biology studies have documented that RUNX2 is of paramount importance for osteoblast differentiation, for regression of the dental lamina, and for osteoclastogenesis in the dental follicle and the periodontal ligament. Jensen & Kreiborg, 25 yr ago, proposed a treatment strategy to be applied to patients with CCD, focussing on the importance of early treatment to promote spontaneous eruption of permanent teeth through extraction of primary teeth, surgical removal of supernumerary teeth, and removal of bone covering the first formed permanent teeth at the time when root formation of the permanent teeth has reached half or two-thirds of their final length. This strategy still seems valid and seems to lead to reduction in the burden of care for patients compared with the treatment protocols otherwise recommended.

Delayed Eruption of Maxillary Central Incisors Associated with the Presence of Supernumerary Teeth: A Case Report with 18 Months Follow-up.

AIM: The aim of this study is to discuss a case of an 11-year-old pediatric patient, who was diagnosed with delayed eruption of the permanent maxillary central incisors because of palatally impacted supernumerary teeth. BACKGROUND: The delayed eruption of permanent teeth can be a result of blocking by supernumerary teeth and over-retained primary teeth. Early diagnosis can help in avoiding the complications. The management of such cases depends on the stage of teeth development, teeth position, and space availability. Treatment may combine both surgical and orthodontic interventions. CASE DESCRIPTION: The case was managed by surgically removing the primary retained teeth and supernumerary teeth in two visits then allowing the impacted permanent incisors to erupt without any intervention. CONCLUSION: After 18 months follow-up, the two permanent incisors erupted spontaneously with no orthodontic intervention. CLINICAL SIGNIFICANCE: dentists should be aware of the importance of early diagnosis of supernumerary teeth. The management of such cases should be designed by a multidisciplinary team decision.

Congenital Feline Hypothyroidism With Partially Erupted Adult Dentition in a 10-Month-Old Male Neutered Domestic Shorthair Cat: A Case Report.

Congenital feline hypothyroidism was diagnosed in a 10-month-old kitten. The kitten appeared to have disproportionate dwarfism, with the clinical signs of incompletely erupted permanent dentition covered by thickened gingival tissue, short stature, a broad, flattened face, short neck, pendulous abdomen, kitten-like hair coat, and goiter. Hypothyroidism was confirmed with baseline T4, freeT4, and thyroid-stimulating hormone testing. The kitten was treated with thyroid hormone supplementation and monitored. The kitten appeared clinically like a normal healthy cat at 22 months of age on thyroid supplementation.

Dental Anomalies in Permanent Teeth after Trauma in Primary Dentition.

OBJECTIVE: This retrospective study aims to evaluate the prevalence of dental anomalies in permanent teeth as a result of a trauma concerning the predecessor primary teeth. STUDY DESIGN: A total of 241 records of children (118 males and 123 females, mean age 3.62 ± 1.40) affected by trauma on primary teeth were analyzed. All patients were recalled to evaluate the status of the permanent successor teeth by clinical and radiographic investigations. RESULTS: Out of 241 patients, 106 patients (for a total of 179 traumatized primary teeth) presented at the recall. Dental anomalies on successor permanent teeth were detected in 21 patients (19.8%), for a total of 26 teeth (14.5%) and 28 anomalies. Anomalies of the eruptive process were the most observed disturbances (60.7%), followed by enamel hypoplasia (25%) and white spots (14.3%). A higher percentage of anomalies on permanent teeth was observed when trauma occurred at an age less than 36 months (38.5% of cases). Intrusive and extrusive luxation were related with the most cases of clinical disturbances in the successor permanent teeth. CONCLUSIONS: The results of this study highlight the risk of dental anomalies after a trauma in primary dentition, especially in early-aged children and in case of intrusive luxation.

Formation and development of maxillary first molars with delayed eruption.

Cases of congenitally missing and delayed eruption of the maxillary first molar are rare. However, in recent years, we have experienced cases of suspected delayed eruption of or congenitally missing first molars. The purpose of this study was to analyze the formation of delayed erupted maxillary first molars (M1) (>2 standard deviations), which play important roles in occlusion, and normal eruption of the maxillary first molars (U6). The frequency of M1 among patients born between 1974 and 1994 in one institution with a clear total patient number and personal oral histories was 1.55 % [80 % bilateral eruption in 8 of 806 male patients (0.99 %) and 23 of 1195 female patients (1.92 %)]. To evaluate the formation and eruption of M1 according to Moorrees's tooth formation stages, panoramic X-ray films were obtained every year for 73 patients with M1 from 3 institutions (20 male and 53 female patients, total 131 M1s) without systematic histories or genetic disorders. The development/growth curve of M1 was fitted to both the logistic curve and U6 curve. The M1 development/growth curve was started behind with U6 curve; however, the straight part of the M1 curve exhibited steep inclination compared with the straight part of the U6 curve. The curve of the eruption pathway of M1 also exhibited a sigmoid S shape. These results indicate that the development and migration speed of M1 are faster than that of U6, excluding the delayed start point. These results may help orthodontists in treatment planning for patients with M1.

Familial Cleidocranial Dysplasia: A Diagnostic Challenge.

Cleidocranial dysplasia (CCD) is a rare genetic disorder affecting primarily the cranium, clavicle, and dental tissues. The expression of this disorder can vary widely in severity, even within the same family. Here we present a case report of an affected mother and son with classical manifestations of the disease.

Metabolic Bone Diseases Affecting Tooth Eruption: A Narrative Review.

Tooth eruption is an essential process for the development of the oral and maxillofacial system. Several inherited and acquired diseases might affect this tightly regulated process, resulting in premature, delayed, or even failed tooth eruption. The purpose of this article is to review the literature and the clinical parameters of metabolic bone diseases that affect tooth eruption. It examines the physiological aspects of tooth eruption and the pathophysiological changes induced by metabolic bone diseases, including changes in bone metabolism, density, and structure. The search strategy for this review included an electronic search in PubMed, Google Scholar, Medline, Scopus, and the Cochrane Library using the following keywords: "metabolic bone diseases", "tooth eruption", "delayed tooth eruption", and each reported disease in combination with "tooth eruption disorders", covering publications up to March 2024 and limited to English-language sources. Understanding the influence of metabolic bone diseases on tooth eruption is crucial for managing both dental and skeletal manifestations associated with these disorders. This review suggests that a multidisciplinary approach to treatment may significantly improve oral outcomes for patients suffering from such conditions. Clinicians should be aware of the specific dental abnormalities that may arise and consider comprehensive evaluations and individualized treatment plans. These findings underscore the need for further research into targeted therapies that address these abnormalities.

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.

Prevalence of Delayed Eruption of Permanent Upper Central Incisors at a Tertiary Hospital in Riyadh, Saudi Arabia.

Tooth eruption is defined as the axial movement of the tooth from its site of development in the alveolar bone to its functional position in the oral cavity. A delay in eruption can directly affect the accurate diagnosis, overall treatment planning, and timing of treatment. Thus, Delayed Tooth Eruption can have a significant impact on a patient's proper health care. This study aimed to estimate the prevalence of delayed eruptions of permanent upper central incisors in Riyadh, Saudi Arabia. A retrospective study assessed panoramic radiographs of children between the ages of 6-10 years old who attended the Dental University Hospital clinics at King Saud University in Riyadh, Saudi Arabia between 2014 and 2020. The radiographs were collected and examined to detect any delayed eruption of the permanent upper central incisors. Panoramic radiographs with delayed erupted permanent upper central incisors were identified by tooth developmental stages and eruption sequence. Of the 745 radiographs, 23 (3.09%) presented at least one delayed erupted permanent upper central incisor of which boys and girls comprised 16 (69.5%) and 7 (30.4%), respectively. Retained primary teeth was the most causative factor of delayed eruption (43.4%), followed by the early loss of primary teeth (21.7%) and insufficient arch space. The present study is the first to assess the prevalence of delayed eruption of the permanent upper central incisors on a Saudi population. Boys were found to have more prevalence of delayed eruption of the permanent upper central incisors compared to girls. Clinicians should be aware of such a condition as early diagnosis of delayed eruption is essential for providing optimal dental care.

Management of Delayed Eruption in Permanent Incisor Following Intrusion Injury of Primary Dentition: A Case Report.

This article describes the clinical management of delayed eruption of the upper left permanent central incisor of an eight-year-old child with a history of overlooked intrusive trauma to the primary maxillary incisors. Initial conservative management involved simple extraction of the over-retained upper right primary left incisor. At the recall visit, the decision was made to expose permanent incisors surgically aiming to facilitate its eruption. Two years later, the upper right central and lateral incisors have been erupted into the oral cavity, improving patient aesthetics. This case report aims to demonstrate the clinical diagnosis and intervention for delayed eruption of maxillary permanent central incisor as a consequence of an overlooked intrusive trauma in the primary dentition. Additionally, to emphasize the importance of periodic radiographic examination in monitoring the sequence of eruption in mixed dentition.

A Novel lncRNA Mediates the Delayed Tooth Eruption of Cleidocranial Dysplasia.

Delayed eruption of permanent teeth is a common symptom of cleidocranial dysplasia (CCD). Previous studies have focused on the anomaly of osteogenesis resulting from mutations in the Runt-related transcription factor-2 gene (RUNX2). However, deficiencies in osteoclastogenesis and bone resorption, and the epigenetic regulation mediated by long non-coding (lnc)RNAs in CCD remain to be elucidated. Here, a novel osteoclast-specific lncRNA (OC-lncRNA) was identified during the osteoclast differentiation of RAW 264.7 cells transfected with a RUNX2 mutation expression cassette. We further confirmed that OC-lncRNA positively regulated osteoclastogenesis and bone resorption. The OC-lncRNA promoted the expression of CXC chemokine receptor type 3 (CXCR3) by competitively binding to microRNA (miR)-221-5p. The CXCR3-CXC-motif chemokine ligand 10 (CXCL10) interaction and nuclear factor-κB constituted a positive feedback that positively regulated osteoclastogenesis and bone resorption. These results demonstrate that OC-lncRNA-mediated osteoclast dysfunction via the OC-lncRNA-miR-221-5p-CXCR3 axis, which is involved in the process of delayed tooth eruption of CCD.

Nonsyndromic delayed eruption of multiple teeth: A rare case report.

Dental eruption is a very finely regulated process. A delay in tooth eruption may be due to a disturbance caused by local, systemic, or genetic abnormalities. Delayed eruption of multiple teeth in the absence of any etiology is very rare. Here, we report a case of delayed eruption in a 16-year-old female patient with multiple congenitally missing teeth and bilaterally ankylosed deciduous teeth with no underlying systemic or genetic disease.

Surgical Management of Unerupted Permanent Maxillary Central Incisors Due to Presence of Two Supernumerary Teeth.

AIM AND OBJECTIVE: The present report aims to present a case of delayed eruption of permanent maxillary central incisors in an 11-year-old male child due to the presence of two supernumerary teeth in anterior maxilla. CASE DESCRIPTION: In this case, clinical and radiographic assessment revealed the presence of two supernumerary teeth palatal to unerupted maxillary permanent central incisors. These teeth were removed surgically under local anesthesia and were diagnosed as supplemental incisor, and the other appeared like tuberculate with dens invaginatus. CONCLUSION: The permanent incisors erupted spontaneously within 6 months follow-up after extraction of the two supernumerary teeth without any orthodontic interception. HOW TO CITE THIS ARTICLE: Alsweed AA, Al-sughier Z. Surgical Management of Unerupted Permanent Maxillary Central Incisors Due to Presence of Two Supernumerary Teeth. Int J Clin Pediatr Dent 2020;13(4):421-424.

Vitamin D deficiency as an etiological factor in delayed eruption of primary teeth: A cross-sectional study.

CONTEXT: Delayed tooth eruption might be the primary or sole manifestation of local or systemic pathology. Aims: The aim of the study was to correlate Vitamin D level and eruption status of primary teeth. The objectives also included the assessment of the association between Vitamin D levels and socioeconomic status, infant's sun exposure, maternal sun exposure during pregnancy and religion. SETTINGS AND DESIGN: A cross-sectional, observational study conducted on 96 infants aged 12-15 months. MATERIALS AND METHODS: Ninety-six infants, aged 12-15 months were selected after obtaining parental consent. Blood samples were assessed for Vitamin D3 levels using the Vitamin D ELISA Kit. The eruption status of the teeth was recorded in all the 96 infants. The obtained data were subjected to the statistical analysis. STATISTICAL ANALYSIS USED: The obtained data were subjected to relevant statistical analysis such as Analysis of Variance, unpaired t-test, Kruskal-Wallis test, and Mann-Whitney U test, Chi-square Test, Tukey HSD, and Fisher's exact Test. Results: A significant correlation was found in the Vitamin D levels and the eruption timing (P < 0.001). The difference in mean Vitamin D levels among the three socio economic groups was not statistically significant (P = 0.088). A significant association was found between the infant's sun exposure and mother's sun exposure during pregnancy and religion on the Vitamin D levels (P = 0.002, P = 0.042, P = 0.002). CONCLUSIONS: Vitamin D deficiency can be considered as an etiological factor for delayed eruption. A strong association exists between the socioeconomic status, infant's sun exposure, maternal sun exposure during pregnancy, and religion with Vitamin D levels.

Multidisciplinary management of delayed eruption of permanent mandibular first molar associated with dentigerous cyst.

The absence of a tooth in the oral cavity may be the result of some obstruction with the process of tooth eruption. Physical obstruction can result from many different causes, such as supernumerary teeth, mucosal barrier, scar tissue, and cysts or tumors. Their removal will usually permit the affected tooth to erupt. This case report describes the delayed eruption of the permanent mandibular first molar in a 9-year-old boy due to the dentigerous cyst associated with it. The management was done through a multidisciplinary approach. Surgical removal of cystic sac through marsupialization along with the removal of the barrier was done. As a consequence of delayed eruption of the permanent first molar, the opposing tooth had supraerupted, which was intruded using mini-implants. Following this, the tooth erupted satisfactorily into the oral cavity to establish class I molar relation.

Retained primary teeth in STAT3 hyper-IgE syndrome: early intervention in childhood is essential.

BACKGROUND: STAT3 hyper-IgE syndrome (STAT3-HIES) is a rare primary immunodeficiency that clinically overlaps with atopic dermatitis. In addition to eczema, elevated serum-IgE, and recurrent infections, STAT3-HIES patients suffer from characteristic facies, midline defects, and retained primary teeth. To optimize dental management we assessed the development of dentition and the long-term outcomes of dental treatment in 13 molecularly defined STAT3-HIES patients using questionnaires, radiographs, and dental investigations. RESULTS: Primary tooth eruption was unremarkable in all STAT3-HIES patients evaluated. Primary tooth exfoliation and permanent tooth eruption was delayed in 83% of patients due to unresorbed tooth roots. A complex orthodontic treatment was needed for one patient receiving delayed extraction of primary molars and canines. Permanent teeth erupted spontaneously in all patients receiving primary teeth extraction of retained primary teeth during average physiologic exfoliation time. CONCLUSIONS: The association of STAT3-HIES with retained primary teeth is important knowledge for dentists and physicians as timely extraction of retained primary teeth prevents dental complications. To enable spontaneous eruption of permanent teeth in children with STAT3-HIES, we recommend extracting retained primary incisors when the patient is not older than 9 years of age and retained primary canines and molars when the patient is not older than 13 years of age, after having confirmed the presence of the permanent successor teeth by radiograph.

Eruption Chronology in Children: A Cross-sectional Study.

AIMS AND OBJECTIVES: The purpose of this study is to determine the appropriate reference standard for eruption timing of primary teeth in infants and preschool children of Bhopal city and to determine the role of various factors affecting the eruption of primary dentition. MATERIALS AND METHODS: A cross-sectional study was conducted among the infants and preschool children (4-36 months) attending the local government or private hospitals, and vaccination centers. Prior to the study, Institutional Ethical Committee clearance and informed written consent from the parents were obtained. The data were collected from full-term infants and preschool children of 4 to 36 months from Bhopal city. Oral examination was done under adequate natural light by a single examiner using mouth mirror and probe. Teeth present in the oral cavity were noted by using Federation Dentaire Internationale system of nomenclature in the preformed pro-forma. The teeth were considered as erupted, when any part of its crown had penetrated the gingiva and was visible in the oral cavity. Height, weight, birth weight, and other close-ended questions in questionnaire were asked from parents. RESULTS AND CONCLUSION: The data collected were statistically analyzed and it was observed that significant relation exists between tooth eruption and birth weight, feeding habits, socioeconomic status, and body mass index (BMI). Based on the findings, it may be concluded that Indian children experienced delayed eruption of primary teeth when compared with children of different countries and standard norms. HOW TO CITE THIS ARTICLE: Verma N, Bansal A, Tyagi P, Jain A, Tiwari U, Gupta R. Eruption Chronology in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(3):278-282.

Achondroplasia with Polydactyly: A Case Report.

An eight-year-old girl child reported to the Department of Oral Medicine and Radiology with the chief complaint of unerupted permanent teeth for past two years. The child presented features like disproportionately short stature, rhizomelic shortening of arms and legs, long face, frontal bossing and saddle nose. Based on the findings of chest and spine radiographs and ultrasound the case was diagnosed as a rare bone disorder "Achondroplasia". This case also presents a unique feature of polydactyly. Polydactyly is a manifestation in clinical medicine because it can serve as an indicator for a plethora of congenital anamolies. This case gained dental interest because of its characteristic craniofacial features. This article highlights the peculiar manifestations of this anamoly.

Characteristics and sequelae of erupted supernumerary teeth: A study of 218 cases among Sri Lankan children.

AIM: In the present study, we investigated the characteristics and sequelae of erupted supernumerary teeth (ST) in a sample of Sri Lankan children. METHODS: Data were recorded from patients' clinical records, radiographs, models, and extracted teeth. RESULTS: The sample consisted of 239 ST from 218 patients. The mean age of the sample was 9.08 ± 2.47 years. The male-to-female ratio was 2.8:1. The majority (42.66%) of patients with ST were in aged 8-10 years. Many (94.94%) of the ST were located in the premaxilla (incisor), followed by the canine (4.22%), premolar (0.42%), and molar (0.42%) regions. The most common shape of ST teeth was conical. Malocclusion (59.83%) was the major problem associated with ST, and the clinical impact was highest on the 8-10-year age group. A strong association was observed between patients' age and clinical impact to the dentition (χ2 =42.09, P=.000). CONCLUSION: Because the majority of ST can lead to malocclusion, especially in mixed dentition, awareness, early detection, and timely clinical intervention of ST are recommended.