Tooth size discrepancies in an orthodontic population

OBJECTIVE: To explore how many millimeters of tooth size discrepancy (TSD) are clinically significant, to determine what percentage of a representative orthodontic population has such a tooth size discrepancy, and to determine the ability of simple visual inspection to detect such a discrepancy. MATERIALS AND METHODS: The sample comprised 150 pretreatment study casts with fully erupted and complete permanent dentitions from first molar to first molar, which were selected randomly from 1100 consecutively treated white orthodontic patients. The mesiodistal diameter tooth sizes were measured using digital calipers, and the Bolton analysis and the tooth size corrections were calculated by the Hamilton Arch Tooth System (HATS) software. Simple visual estimation of Bolton discrepancy was also performed. RESULTS: In the sample group 17.4% had anterior tooth-width ratios and 5.4% had total arch ratios greater than 2 of Bolton's standard deviations from Bolton's mean. For the anterior analysis, correction greater than +/- 2 mm was required for 16% of patients in the upper arch or 9% in the lower arch. For the total arch analysis, the corresponding figures are 28% and 24%. CONCLUSIONS: It is recommended that 2 mm of required tooth size correction is an appropriate threshold for clinical significance. A significant percentage of patients have a TSD of this size. Visual estimation of TSD has low sensitivity and specificity. Careful measurement is more frequently required in clinical practice than visual estimation would suggest.     

Tooth agenesis and craniofacial morphology in pre-orthodontic children with and without morphological deviations in the upper cervical spine

AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis in the two groups together. METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with (19 children, mean age 11.9) and without (107 children, mean age 11.4) upper spine morphological deviations. Visual assessment of upper spine morphology and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms. RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations (2.2 ± 1.6 vs 1.94 ± 1.2, P > 0.05) but a tendency to a different tooth agenesis pattern were seen in children with morphological deviations in the upper spine. In the total group tooth agenesis was associated with the cranial base angle (n-s-ba, r = 0.23, P < 0.01), jaw angle (ML/RLar, r = 0.19, P < 0.05), mandibular inclination (NSL/ML, r = -0.21, P < 0.05), mandibular prognathia (s-n-pg, r = 0.25, P < 0.01), sagittal jaw relationship (ss-n-pg, r = -0.23, P < 0.5), overjet (r = -0.23, P < 0.05) and overbite (r = -0.25, P < 0.01). CONCLUSION: Etiology of tooth agenesis in children with upper spine morphological deviations was discussed. The results may be valuable for the early diagnosis and treatment planning of non syndromic children with tooth agenesis.     

Hypodontia patterns and variations in craniofacial morphology in Japanese orthodontic patients

OBJECTIVE: The purpose of this study was to explore the association of hypodontia patterns and variations in craniofacial morphology in Japanese orthodontic patients. MATERIALS AND METHODS: A total of 50 girls with hypodontia (the total group) were selected and categorized into anterior, posterior, and anterior-posterior groups according to the location of the congenitally missing teeth. By using the lateral cephalograms of each subject, 28 angular and 37 linear measurements were made. The cephalometric data were statistically analyzed and compared among the groups and with the Japanese cephalometric standards from 36 age-matched female subjects without hypodontia or malocclusion (the control group). RESULTS: Every hypodontia group showed shorter anterior and overall cranial base lengths, shorter maxillary length, greater retroclination and elongation of mandibular incisors, and a larger interincisal angle than the control group. The total and anterior-posterior groups especially exhibited a significantly more prognathic mandible, larger retroclination of maxillary incisors, and a more counterclockwise-rotated occlusal plane. Furthermore, these skeletal and dental deviations were more remarkable in the anterior-posterior group than in either the anterior or the posterior group. Anterior hypodontia exerted as much influence on craniofacial morphology as posterior hypodontia. CONCLUSIONS: When orthodontic treatment is performed on patients with hypodontia, not only the number but also the distribution of missing teeth should be taken into consideration, though there was no significant difference in craniofacial morphology between anterior hypodontia and posterior hypodontia.     

Association of advanced hypodontia and craniofacial morphology in Japanese orthodontic patients

The purpose of this study was to examine the effects of advanced hypodontia on craniofacial morphology in Japanese patients. We defined advanced hypodontia as a congenital absence of four or more permanent teeth, excluding the third molars. Lateral cephalometric radiographs of 20 female orthodontic patients (age range, 8.5 to 19 years; mean age, 13.9 years) were examined. Twenty-eight angular and 37 linear measurements were taken from each cephalogram, and these cephalometric data were statistically analyzed and compared with the Japanese cephalometric standards. The most frequently missing teeth were the mandibular and maxillary second premolars, followed by the maxillary first premolars and the maxillary first molars, in that order. Compared with the Japanese standards, a smaller cranial base length and angle, a shorter maxillary length, a slightly prognathic and upward-rotated mandible, and retroclination of the upper and lower incisors were found in the patients studied. These craniofacial anomalies should be taken into consideration in treatment planning and mechanotherapy.     

Prevalence of maxillary lateral incisor agenesis and associated skeletal characteristics in an orthodontic patient population

Objectives: This study was aimed to investigate the prevalence of maxillary lateral incisor agenesis and associated skeletal characteristics in an orthodontic patient population.

Materials and methods: The records of the 1066 patients seeking orthodontic treatment were screened for maxillary lateral incisor agenesis (MLIA). The following data were recorded for each subject: age; gender; unilateral or bilateral agenesis of MLI and side. The lateral cephalogram of each subject with MLIA was digitally traced. The data were compared to age-matched control orthodontic patients with skeletal Class I.

Results: The prevalence of maxillary lateral incisor agenesis was 4.9% (52 patients) in which 63.5% were females. There was a significant difference between MLIA patients and controls in sagittal relationships (ANB, Wits, AB plane, angle of convexity and Co-A/Co-Gn differential analyses) p?Conclusions: Patients with maxillary lateral incisor agenesis showed a significant tendency for skeletal Class III compared with the Class I control. This could be attributed to maxillary hypoplasia/retrognathia.     

Tooth loss and craniofacial factors associated with changes in mandibular condylar morphology

Objective: To investigate the association between tooth loss and craniofacial factors with changes in mandibular condylar morphology.

Methods: A total of 123 patients participated in this cross-sectional study. The mandibular condylar morphology was evaluated using digital panoramic radiography. The exposure variables included gender, age group, molar relationship, facial growth pattern, facial asymmetry, dental midline, posterior crossbite, presence of fixed dental prosthesis, and tooth loss.

Results: Unilateral and bilateral mandibular condyle structural alterations were found in 20.3% and 28.5% of the sample, respectively. After the adjustment analysis, posterior crossbite (adjusted OR = 3.34, 95% CI = 1.23–9.06) and tooth loss (adjusted OR = 4.08, 95% CI = 1.72–9.64) were associated with the outcome. The tooth type associated with mandibular condyle structural alterations were premolars and upper molars.

Conclusion: The findings suggest that posterior crossbite and tooth loss are associated with mandibular condyle structural alterations.     

Tooth eruption and orthodontic movement.

Teeth have been moved in man for centuries and the process of tooth eruption has occurred presumably since he evolved. The cellular and molecular mechanisms which are involved in these two phenomena are amongst the most intriguing questions in dental research today. The aim of this paper is to review some of the theories which have been proposed to explain the two processes. It is also intended to place in context the contribution being made by biological sciences, which might explain tooth eruption and tooth movement. It is not the intention to describe morphologic observations which are well documented and illustrated in more elaborate texts.     

Patterns of non-syndromic permanent tooth agenesis in a large orthodontic population

ObjectiveThe aim of this study is to explore patterns of non-syndromic permanent tooth agenesis in a large orthodontic patient group.DesignA record review was performed in various orthodontic clinics to identify white patients with non-syndromic permanent tooth agenesis, excluding 3rd molars. Four hundred and fourteen subjects fulfilled the inclusion criteria.ResultsIn the 414 subjects with tooth agenesis, approximately 70% presented 1–2 missing teeth. Symmetric agenesis patterns were often observed in the sample (by jaw, by side, or crossed quadrants), with prevalence approaching 30% for cases with contralateral tooth agenesis within a jaw. In cases with 1 or 2 missing teeth, from the total number of potential tooth agenesis patterns in the sample, a certain part was evident, limiting the variation to 27.8% (44/158). In the entire sample, both in the maxilla and the mandible a certain incisor/premolar agenesis phenotype was observed in 59.0% of cases in isolated form.ConclusionsAlthough there was variation in the tooth agenesis patterns, our findings suggest the involvement of particular genetic, epigenetic, and/or environmental factors in the formation of the entire dentition, which often lead to specific tooth agenesis phenotypes in cases where this process is disrupted.The present study provides a comprehensive categorization of orthodontic cases with tooth agenesis and can assist in planning future epidemiological and genetic studies.     

Association between condylar position, joint morphology and craniofacial morphology in orthodontic patients without temporomandibular joint disorders

The present study investigated condylar position and joint morphology in adolescent patients and elucidated the possible association between the joint structure and condylar position, and craniofacial morphology. Sixty-five adolescent patients were selected as subjects and their tomograms and lateral cephalograms were analysed. No significant differences in joint spaces were found between the right and left temporomandibular joints. Both the condyles in this population were located slight anteriorly in the glenoid fossa. With respect to the association between condylar position, joint morphology and craniofacial morphology, the ramus plane angle also exhibited significant negative correlations with posterior, lateral and medial joint spaces. Furthermore, there was a significant negative correlation between the gonial angle and the anterior joint space. These findings imply that the condyle was likely to show more posterior position in the glenoid fossa when the mandible exhibited clockwise rotation. In conclusion, the condyle in the adolescent subjects showed a symmetrical anterior position relative to the glenoid fossa. In addition, the joint spaces and it ratios were significantly related to the craniofacial morphology associated with vertical dimension. It is suggested that the condylar position may be affected by craniofacial growth pattern.     

Association between skeletal morphology and agenesis of all four third molars in Japanese orthodontic patients

The purpose of this study was to clarify differences in skeletal morphologies between male and female orthodontic patients with and without agenesis of all four third molars. A total of 64 patients (32 males and 32 females) with agenesis of all four third molars without agenesis of other teeth were selected as the third molars agenesis group (group 1). In addition, 64 patients (32 males and 32 females) with all these teeth were selected as controls (group 2). Lateral cephalograms taken between the ages of 14 and 30 years were used to compare skeletal morphology between groups 1 and 2 and between sexes. Maxillary length (P < 0.001), lower facial height (P < 0.05), gonial angle (P < 0.001) and mandibular plane angle (P < 0.001) were significantly smaller in group 1 than in group 2. Irrespective of the presence or absence of all four third molars, males had significantly smaller lower facial height (P < 0.01) and mandibular plane angle (P < 0.001) and significantly greater total mandibular length (P < 0.001), mandibular body length (P < 0.001) and mandibular ramus height (P < 0.001) than females. Japanese orthodontic patients with agenesis of all four third molars had significantly small maxillary length, lower facial height, gonial angle and mandibular plane angle.     

Investigation of the maxillary lateral incisor agenesis and associated dental anomalies in an orthodontic patient population

Objectives: The aim of this study was to investigate the prevalence of maxillary lateral incisor (MLI) agenesis and associated dental anomalies as well as skeletal patterns in an orthodontic population, and then to compare it with the prevalence of these anomalies in the general population.Study Design: The material of the present study included the records of the 3872 orthodontic patients. The followings were recorded for each subject with the agenesis of MLI: Age, sex, unilateral or bilateral absence, anterior-posterior skeletal relationship of the maxilla and mandible, and presence of associated dental anomalies. The occurrence of these anomalies was compared with data previously reported for the general populations. Results: Of the 3872 patients examined, 94 were found to have agenesis of the MLI, representing a prevalence of 2.4 per cent, with females being more frequently observed. The most commonly found associated anomalies were ectopic eruption of maxillary canines and reduced or peg- shaped contralateral incisor with the frequencies of 21.3 per cent and 20.2 per cent respectively.Conclusions: Patients with agenesis of MLI showed a significantly higher prevalence of skeletal Class III malocclusion compared with the general population. The prevalence of ectopic eruption, transposition, and transmigration of the maxillary canine and reduced or peg- shaped MLIs were significantly increased. Key words:Hypodontia, missing laterals, associated dental anomalies.     

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.