A survey of hypodontia in Japanese orthodontic patients.

INTRODUCTION: The purpose of this retrospective study was to assess the prevalence and distribution of hypodontia in the permanent dentition, excluding the third molars, in a sample of Japanese orthodontic patients. METHODS: Orthopantomograms of 3358 Japanese orthodontic patients (1453 boys and 1905 girls) between the ages of 5 and 15 years were examined for evidence of hypodontia. RESULTS: The prevalence of hypodontia was 8.5% (7.5% for boys, 9.3% for girls) with no statistically significant difference between the sexes. The average number of missing teeth per child was 2.4 (2.5 for boys, 2.4 for girls). Most (76.3%) children with hypodontia were missing either 1 or 2 teeth (77.1% for boys, 75.7% for girls). The prevalence of advanced hypodontia was 10.1% (11.0% for boys, 9.7% for girls). The most commonly missing teeth were the mandibular second premolars, followed by the mandibular and maxillary lateral incisors, and the maxillary second premolars; minor differences in the order of prevalence existed among groups of children classified by the number of missing teeth. Symmetrical hypodontia was predominant, and the most commonly symmetrical hypodontia was mandibular second premolar agenesis. No consistent finding was obtained as to which jaw had more missing teeth. The distribution of missing teeth was similar between the right and left sides of the dental arches in each group of children. Anterior tooth agenesis was predominant in children with minor hypodontia, and posterior tooth agenesis increased with hypodontia severity. CONCLUSIONS: The distinct characteristic of hypodontia in the Japanese population compared with other populations was a higher prevalence of both advanced hypodontia and mandibular lateral incisor agenesis in children with minor hypodontia.     

Non-syndromic hypodontia in an Iranian orthodontic population

To investigate the prevalence, characteristics (ie, malocclusion, location, type), and sex distribution of hypodontia in an Iranian orthodontic population. A retrospective study was conducted using periapical and panoramic radiographs and study models of 1,751 subjects attending university orthodontic clinics (870 females, 881 males, age 9-27 years). The Chi-square test was used to analyze differences in the distribution of hypodontia, after stratification by sex and malocclusion type. A total of 197 congenitally missing teeth were observed in 160 patients (9.1%; 74 boys and 86 girls); there were no statistically significant differences between sexes (Chi-square = 0.832, P = 0.36). Hypodontia was more common in patients with Class III malocclusion (45.2%), and was more prevalent in the maxilla (71%) than in the mandible (29%). Maxillary lateral incisors (35.6%) and maxillary second premolars (13.0%) were the most commonly missing teeth, followed by mandibular lateral incisors (9.6%) and mandibular second premolars (8.2%). The prevalence of missing teeth was higher in the anterior segment (incisors and canines) than in the posterior segment (premolars and molars). The prevalence of oligodontia was 0.34%. The prevalence and characteristics of the most frequently missing teeth accorded with the findings of most studies conducted in other countries.     

石家庄地区正畸患者恒牙先天缺失的调查分析

目的调查分析石家庄地区正畸患者恒牙先天缺失的发病率及特征。方法对河北医科大学口腔医院正畸科2010~2012年正畸患者中3274名有效病例的病历资料进行回顾分析。通过观察其全颌曲面断层片,分析恒牙先天缺失的发病率及分布差异。结果除第三磨牙外恒牙先天缺失的发病率为9.13,性别间差异无统计学意义（P〉0.05）。个别缺牙例数（缺牙数〈6）占总缺牙例数的95,其中缺失1~2颗牙的例数占总缺牙例数的88.6;多数缺牙例数（缺牙数≥6）占总缺牙例数的5。前、后牙区的缺牙发病情况在缺失1~2颗牙时,主要发生在前牙区,缺失2颗以上时,后牙区的缺失发病率高于前牙区（P〈0.05）;下颌缺牙发病率高于上颌（P〈0.05）。缺牙频率最高的是下颌侧切牙（25.3）,其次是下颌第二前磨牙（18.3）。结论石家庄地区正畸患者恒牙先天缺失（不包括第三磨牙）发病率为9.13,。其中以缺失1~2颗牙最常见,恒牙先天缺失更多的发生在前牙区及下颌,最常见的缺失牙位是下颌侧切牙和下颌第二前磨牙。     

Radiographic assessment of congenitally missing teeth in orthodontic patients

Summary. Objective. To estimate the prevalence of congenitally missing teeth (CMT) in patients evaluated for orthodontic care. A sample of 668 panoramic radiographs from Mexican population was reviewed from orthodontic healthy patients, 9–20 years old. Method. Statistical tests were used to compare maxillary and mandibular hypodontia in right and left quadrants between males and females. Results. Prevalence was 27% when all teeth were included, and was 2·7% when third molars were excluded. A significant difference was found between maxillary and mandibular symmetrical CMT in third maxillary molars, lateral incisors and second premolars (P < 0·001), and in mandibular third molars and central incisors (P < 0·001). Conclusions. We confirmed that occurrence of CMT in the permanent dentition of a Mexican population most often affects third molars, followed by maxillary lateral incisors and then mandibular second premolars.     

Clinical management of the congenitally missing maxillary lateral incisor and mandibular second premolar: a clinical perspective

The decision to close maintain, or open space at the agenesis sites of the maxillary lateral incisor and mandibular second premolar is generally based on several factors, including the class of malocclusion, skeletal pattern (divergence), esthetics, function, and periodontics. Replacement of congenitally missing maxillary lateral incisors, the second most commonly missing teeth, can involve (1) canine replacement, (2) tooth-supported restoration, and (3) implants. This paper contrary to the opinion of other authors, favors replacement of the congenitally missing lateral incisors in one of several ways, versus orthodontic space closure.     

Congenitally missing mandibular second premolar: treatment outcome with orthodontic space closure

Orthodontic treatment for patients with congenitally missing mandibular second premolars can be challenging. Treatment options include keeping the deciduous second molar, extracting the molars and allowing the space to close spontaneously, autotransplantation, prosthetic replacement, and orthodontic space closure. Space closure with orthodontic appliances is demonstrated in this case report.     

The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment

Orthodontic treatment for patients with uni- or bilateral congenitally missing lateral incisors is a challenge to effective treatment planning. The two major alternatives, orthodontic space closure or space opening for prosthetic replacements, can both compromise aesthetics, periodontal health, and function. The aim of this retrospective study was to examine treated patients who had congenitally missing lateral incisors and to compare their opinion of the aesthetic result with the dentists' opinions of occlusal function and periodontal health. In this sample, 50 patients were identified. Thirty had been treated with orthodontic space closure, and 20 by space opening and a prosthesis (porcelain bonded to gold and resin bonded bridges). The patient's opinion of the aesthetic result was evaluated using the Eastman Esthetic Index questionnaire and during a structured interview. The functional status, dental contact patterns, periodontal condition, and quality of the prosthetic replacement was evaluated. In general, subjects treated with orthodontic space closure were more satisfied with the appearance of their teeth than those who had a prosthesis. No significant differences in the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) were found. However, patients with prosthetic replacements had impaired periodontal health with accumulation of plaque and gingivitis. The conclusion of this study is that orthodontic space closure produces results that are well accepted by patients, does not impair temporomandibular joint (TMJ) function, and encourages periodontal health in comparison with prosthetic replacements.     

儿童口腔科门诊先天缺牙患者临床特征和发病因素研究

目的    研究儿童口腔科门诊先天缺牙患者的临床特征和可能影响发病的因素。方法    对2014年1—12月于中国医科大学附属口腔医院儿童口腔科就诊的16 320例患者进行先天缺牙的临床调查,针对先天缺牙的部位、数目及可能影响发病的因素等进行分析。结果    326例患者确诊为先天缺牙,占调查患者人数的2.0 %。其中,多数牙缺失患者44例,平均缺牙数为（7.98 ± 2.98）颗;个别牙缺失患者282例,平均缺牙数为（2.09 ± 1.04）颗。多数牙缺失患者中具有家族遗传史者所占比例明显高于个别牙缺失患者。缺牙好发部位依次为下颌第二前磨牙、上颌第二前磨牙、上颌侧切牙、下颌中切牙、第一前磨牙、上颌尖牙。采用非条件Logistic回归对先天缺牙的可能影响因素进行分析,发现家族史是先天缺牙的危险因素（P < 0.01）,而患者父母的文化程度、母亲受孕年龄、母亲妊娠期放射线接触史及是否为早产儿等因素,均不是先天缺牙的影响因素（P > 0.05）。结论    先天缺牙多为个别牙缺失,好发部位主要为下颌第二前磨牙;多数牙缺失可能与家族遗传密切相关。     

��ͯ��ǻ����������ȱ�������ٴ������ͷ��������о�

??Objective    To investigate the clinical characteristics and possible related factors of tooth agenesis in the patients in the pediatric dentistry. Methods    A total of 16320 children?? who came to Pediatric Dentistry Clinic of Stomatology Hospital affiliated to China Medical University from January to December in 2014?? were examined. The number?? position and the influencing factors were analyzed. Results    Totally 326 children were diagnosed with tooth agenesis?? accounting for 2.0%. Among these patients?? 44 were oligodontia with the average number of missing teeth at 7.98 ± 2.98?? 282 were hypodontia with the average number of missing teeth at 2.09 ± 1.04. The proportion of children with family history in oligodontia was significantly higher than that in hypodontia. Most of the missing teeth were located in the second mandibular premolar?? followed by the second maxillary premolar?? maxillary lateral incisor?? mandibular central incisors?? the first molar and maxillary cuspid. Influencing factors for tooth agenesis were analyzed by non-conditional Logistic regression. Family history was a risk factor for congenital missing teeth ??P < 0.01??. Parents' educational level?? pregnancy age?? history of radiation exposure during pregnancy and preterm birth were not the influencing factors for tooth agenesis ??P > 0.05??. Conclusion    Hypodontia is the most common type of tooth agenesis and the second mandibular premolars are predominantly affected. Oligodontia might be closely relate to genetic factor.     

Maxillary impacted canine with congenitally absent premolars

Multiple treatment options are available to patients who have impacted canines in addition to congenitally absent premolars. Management options for impacted maxillary canines can include (1) continued observation, (2) extraction of the primary canine to aid spontaneous eruption, (3) uncovering and bonding of the impacted tooth and its eruption using orthodontic traction, (4) autotransplantation, and (5) extraction followed by prosthetic replacement. The options for the treatment of missing premolars can include the following: (1) maintaining the primary molars, (2) spontaneous space closure after early extraction of the primary molar, (3) autotransplantation, (4) prosthetic replacement, and (5) orthodontic space closure. In this case report, treatment of a patient with an impacted maxillary canine and agenesis of three second premolars will be presented.     

Nonprosthodontic management of alveolar clefts with 2 incisors missing on the cleft side: A report of 5 patients

A treatment combining autotransplantation of developing premolars and orthodontic space closure is described as an alternative to prosthodontics in the management of patients with alveolar clefts when 2 cleft-side incisors are missing. We report on 5 consecutive patients with unilateral clefts in whom 2 cleft-side incisors were congenitally missing, severely malformed, ectopically erupting, or lost because of trauma. In each instance, a mandibular premolar with a partly developed root was transplanted to the central incisor region (3 patients had previously undergone alveolar bone grafting). Root growth continued in all transplants. After an observation period of 2 years 6 months to 7 years 8 months, all transplanted teeth were present and fulfilled the established success criteria. The physiologic status of the transplanted premolars compared favorably with that of the central incisor on the noncleft side. The appearance of the reshaped transplants was found to match the noncleft incisor in 3 patients and deviated somewhat in 2. We concluded that an acceptable clinical outcome can be obtained by tooth transplantation combined with orthodontic space closure in patients with alveolar clefts and 2 missing cleft-side incisors.     

Tooth dimensions in hypodontia patients,their unaffected relatives and a control group measured by a new image analysis system

Tooth dimensions were compared between index patients with severe hypodontia (six or more congenitally missing teeth), their relatives with a full complement of teeth, and a control group. The groups consisted of 12 index cases (seven females and five males), 21 relatives without hypodontia (13 females and eight males), and a control group of 10 males and 10 females with complete dentitions, and no family history of hypodontia. All formed teeth were imaged buccally and occlusally from study models, with a digital camera linked to a computer. The images were acquired and measured using Adobe Photoshop and Image Pro Plus, respectively. Mesiodistal, buccolingual, or occlusogingival area and perimeter measurements were determined from each image. In the index hypodontia group tooth dimensions were significantly smaller (P < 0.001, Bonferroni corrected level) for maxillary and mandibular canines, and first premolars for all dimensions from the buccal view, and for maxillary and mandibular canines and first premolars, maxillary central incisors, maxillary first molars, mandibular lateral incisors, and mandibular second premolars for all dimensions from the occlusal view. In the relatives without hypodontia compared with the control group, mesiodistal dimensions from the buccal view were significantly smaller (P < 0.001) for the central incisors and maxillary first and second premolars, and for the maxillary and mandibular first premolars for all dimensions from the occlusal view. There was a trend for the tooth dimensions of all teeth in the index group to be smaller compared with the control group. The tooth dimensions of the relatives without hypodontia also tended to be smaller than the control group, but were larger than those of the index cases.     

Dental Findings in Patients with Ectodermal Dysplasia

BACKGROUND: Ectodermal dysplasia is an inherited disease causing malformations of all tissues originating from the ectoderm. The significance of this disease lies in severe hypodontia, and an accompanying hypoplasia of the alveolar process. The clinical situation is aggravated by a significant xerostomia. It was the aim of this study to document the distribution of hypodontia and tooth malformation. Furthermore, we aimed to elucidate the clinical impact of these findings. PATIENTS AND METHODS: Records of 30 patients (19 males, 11 females) suffering from ectodermal dysplasia were included. Their age ranged between 7 and 23 years. All patients had been examined clinically and radiographically. In every patient, a record was made of which teeth were missing or malformed, and which deciduous teeth persisted. Additionally, the entire treatment procedure was assessed. RESULTS: The third molars were missing in all of the patients. The number of aplastic permanent teeth ranged from 2 to 26. The maxillary lateral incisors were most frequently absent, followed by the mandibular central incisors. The most stable teeth were the central incisors of the upper jaw, and the canines and first molars in both jaws. However, the maxillary central incisors and canines were the teeth most affected by malformation. Deciduous canines and second molars were the most often persisting teeth due to agenesis of the maxillary lateral permanent incisors and mandibular second premolars. In two-thirds of the patients, missing teeth were replaced by removable dentures. Half of the patients received orthodontic treatment. CONCLUSIONS: Hypodontia and malformation are almost regular dental characteristics in patients suffering from ectodermal dysplasia. The distribution of absent teeth deviates remarkably from the general population. Treatment requires an interdisciplinary approach including orthodontics, prosthodontics and oral surgery.     

Patterns of tooth agenesis in Japanese subjects with bilateral agenesis of mandibular second premolars

The aim of this study was to explore the patterns of tooth agenesis in Japanese orthodontic patients with bilateral agenesis of mandibular second premolars. A total of 80 Japanese orthodontic patients with 2 congenitally missing mandibular second premolars were selected as the subjects of this study (experimental group). Another 80 individuals without bilateral agenesis of mandibular second premolars were collected for comparison (control group). The 2 groups were matched with regard to sex. Radiographs, dental casts and records of medical and/or dental treatment were used to identify tooth agenesis. The Chi-square test, odds ratio, and test for equality were used to make statistical comparisons. The prevalence rates of other types of tooth agenesis were significantly higher in the experimental group than in the control group. The occurrence of agenesis of maxillary and mandibular lateral incisors and third molars, and maxillary second premolars was also significantly higher in the experimental group than in the control group. Significantly increased prevalence rates of symmetrical tooth agenesis, with third molars included, and oligodontia were observed in the experimental group. Japanese subjects with bilateral agenesis of mandibular second premolars are at significantly high risk of agenesis of other types of permanent teeth, symmetrical tooth agenesis and oligodontia.     

Hypodontia in 9-year-old Norwegians related to need of orthodontic treatment

The present study reports on the prevalence of hypodontia in a Norwegian population and classifies children with hypodontia according to need of orthodontic treatment. Orthopantomograms of 1953 children (960 girls and 993 boys) at the age of 9 were available for examination. Of the boys registered with hypodontia of second premolars at the age of 9, 11.3% showed late mineralization between the ages of 9 and 12. Only 2.9% of the girls showed late mineralization. The corrected prevalence of hypodontia, excluding third molars, in the girls was 7.2%, in the boys 5.8%, and in both sexes combined 6.5%, the difference between sexes not being statistically significant. Of the children with hypodontia, 86.6% lacked only one or two permanent teeth. The most frequently missing teeth were the mandibular second premolars, the maxillary second premolars, and the maxillary lateral incisors, in that order. Classification of children with hypodontia according to need of orthodontic treatment showed that about two-thirds had hypodontia only of single posterior teeth with a moderate need of treatment. About one-third had hypodontia involving anterior teeth, and only 3.1% had hypodontia of two or more teeth in the same quadrant with a great need of treatment.     

Effectiveness of computer-assisted orthodontic treatment technology to achieve predicted outcomes

Objective:To evaluate the effectiveness of computer-assisted orthodontic treatment technology to produce the tooth position prescribed by the virtual treatment plan.Materials and Methods:Posttreatment models of 23 patients treated with SureSmile were digitally superimposed on their corresponding virtual treatment plan models utilizing best-fit surface-based registration. Individual tooth-position discrepancies between virtual treatment plan and actual outcome were computed. Discrepancies less than 0.5 mm in mesial-distal, facial-lingual, and vertical dimensions, and less than 2° for crown torque, tip, and rotation were considered clinically ideal. One-sided test of equivalence was performed on each discrepancy measurement, with P < .05 considered statistically significant.Results:Mesial-distal tooth position was clinically ideal for all teeth with the exception of maxillary lateral incisors and second molars. Facial-lingual tooth position was clinically ideal for all teeth except maxillary central incisors, premolars, and molars, and mandibular incisors and second molars. Vertical tooth position was clinically ideal for all teeth except mandibular second molars. For crown torque, tip, and rotation, discrepancy exceeded the limits considered clinically ideal for all teeth except for crown torque on mandibular second premolars and crown tip on mandibular second premolars and first molars.Conclusions:The effectiveness of computer-assisted orthodontic treatment technology to achieve predicted tooth position varies with tooth type and dimension of movement.     

Consecutive tooth agenesis patterns in non-syndromic oligodontia

Agenesis of two or more consecutive adjacent permanent teeth (consecutive tooth agenesis, CTA) is a serious manifestation of oligodontia requiring long-term, multi-disciplinary treatment. Therefore, the present study investigated the characteristics of the CTA pattern in orthodontic patients with non-syndromic oligodontia. Using panoramic radiographs, the number of agenetic permanent teeth excluding third molars in non-syndromic orthodontic patients was evaluated, and patients with six or more agenetic teeth (oligodontia group, n?=?97) and with one to five agenetic teeth (hypodontia group, n?=?107) were selected. The numbers of CTA including third molars in each quadrant and in each patient were compared between the groups. Each quadrant with CTA of patients was categorized into one of the following four types: (I) involves anterior teeth only; (II) involves posterior teeth only; (IIIA) includes anterior and posterior teeth; and (IIIB) separate in the anterior and posterior teeth. CTA in at least one quadrant was found in 91.8 and 4.7% of patients in the oligodontia and hypodontia groups, respectively. The highest frequency CTA patterns included agenesis of the first and second premolars and of the second and third molars in the oligodontia and hypodontia groups, respectively. In the oligodontia group, type IIIA was significantly more frequent in the maxillary than in the mandibular quadrant. Most oligodontia patients who visit orthodontic clinics have CTA. A rare but severe CTA pattern that continues from the anterior to posterior segments is more frequent in the maxillary than in the mandibular quadrant.

     

Hypodontia in orthodontically treated children

The frequency of hypodontia in orthodontically treated children, both male and female, and the association between tooth type, the upper or lower arch, the affected side and Angle's classification were studied using interviews, oral, study cast and panoramic radiographic examinations of 212 patients with a mean age of 12 years 7 months. A hypodontia frequency of 11.3 per cent was found for the total sample. This was higher than the incidence of hypodontia reported in other studies of orthodontically treated children. The most frequently missing teeth were the maxillary lateral incisors, and maxillary and mandibular second premolars. The missing teeth were more often absent on the right (54.2 per cent) than on the left (45.8 per cent) side, in both males and females. One tooth was absent in 29.2 per cent of patients, two in 58.5 per cent, but seldom three or more. Orthodontic space closure was the treatment of choice in 87.5 per cent of the subjects.