Patterns of bilateral agenesis of maxillary third molars and agenesis of other teeth

The purpose of this study was to investigate the patterns of bilateral agenesis of maxillary third molars and other tooth agenesis in Japanese orthodontic patients. A group of 262 subjects with bilateral agenesis of maxillary third molars (group A) was divided into three subgroups: group 1A consisting of 114 subjects without agenesis of mandibular third molars; group 2A, 31 subjects with unilateral agenesis of mandibular third molars; and group 3A, 117 subjects with agenesis of all third molars. As controls, 926 other subjects without third molar agenesis were selected (group C). Panoramic radiographs were mainly used to examine for tooth agenesis. The Chi square test and odds ratio were used to make statistical comparisons. The prevalence rates of agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, and bilateral agenesis of maxillary lateral incisors and second premolars were significantly higher in any one of the third molar agenesis groups than in the control group. Characteristically, no significant increase in occurrence of bilateral agenesis of mandibular second premolars was demonstrated by the subjects with bilateral agenesis of maxillary third molars. Irrespective of whether unilateral or bilateral agenesis of mandibular third molars is present or not, the Japanese orthodontic patients with bilateral agenesis of maxillary third molars exhibited a significantly increased occurrence of unilateral or bilateral agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, except for bilateral agenesis of mandibular incisors and second premolars.     

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.     

乌鲁木齐地区青少年恒牙形态及数目异常的分析

目的探讨乌鲁木齐地区青少年先天缺失牙、多生牙、过小牙的发生率及好发部位。方法本文观察和分析了620例患者的全颌曲面体层X线片．均无恒牙拔牙史或牙齿损伤史。结果先天缺失牙（包括第三磨牙）的发生率为45．48％,第三磨牙的缺失发生率为32．58％,缺失牙的好发部位依次为上颌第三磨牙、下颌第三磨牙、下颌侧切牙、下颌中切牙、上颌第二双尖牙等;多生牙发生率为2．58％,好发部位是上颌切牙区。过小牙的发生率为6．30％．其主要为上颌侧切牙。结论牙齿先天缺失在人群中的发生率明显高于多生牙．缺失牙主要发生在功能相对弱的牙位上：缺失牙与过小牙之间存在一定联系．     

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.     

阻生前磨牙的临床研究现状

阻生牙是口腔中较常见的一种发育畸形,以尖牙、第三磨牙、中切牙、前磨牙及第二磨牙的阻生多见,尤以下颌第三磨牙及上颌尖牙阻生的患病率最高。目前国内外学者对阻生牙的研究主要集中在上颌尖牙和第三磨牙方面,对阻生前磨牙的研究甚少。临床上,很大一部分正畸患者需要进行拔牙矫治,且拔牙牙位主要位于前磨牙区,可见阻生前磨牙对正畸矫治设计及预后影响极大。本文对阻生前磨牙现有的研究状况进行综述,对阻生前磨牙的流行病学特点、临床定位和治疗方法进行总结,以期为正畸医生制定正畸矫治计划提供参考。     

Efficacy of resin-modified glass ionomer cement varnish in the prevention of white spot lesions during comprehensive orthodontic treatment: a split-mouth study

Abstract

Objective:

To evaluate the efficacy of resin-modified glass ionomer cement varnish in the prevention of white spot lesions (WSLs) during early orthodontic treatment with fixed appliances.

Materials and methods:

A total of 480 maxillary and mandibular anterior teeth were studied. The varnish was applied to either the right or left side of the maxillary or mandibular anterior teeth on a random basis. For each experimental quadrant in each patient, the varnish was applied to the labial surfaces of incisors and canines, from the gingival surface of the bracket to the free gingival margin. White spot lesions were recorded on a standard pro forma before (T ₀) and approximately 6?months following varnish application (T ₁) by DIAGNOdent and direct visual inspection.

Results:

The DIAGNOdent score at T ₁ was increased significantly in the control maxillary lateral and mandibular central (P?<?0·05), and lateral incisors (P?<?0·01). The visual scores in experimental maxillary lateral incisors and mandibular canines were decreased significantly at T ₁ (P?<?0·05). The sidewise post-treatment (T ₁) comparisons of control and experimental teeth for visual scores revealed significant decreases for maxillary lateral incisors, maxillary canines and mandibular canines (P?<?0·05).

Conclusion:

Application of resin-modified glass ionomer cement varnish had a favourable effect in the prevention of WSLs during comprehensive orthodontic treatment.     

Familial cases of missing mandibular incisor: three case presentations

Hypodontia is the congenital absence of one or more teeth because of agenesis. The most commonly missing teeth are the third molars, the maxillary lateral incisors and the second premolars. Cases are presented of three patients with a missing mandibular incisor.     

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.     

Hypodontia in children with various types of clefts

The prevalence of hypodontia in children with clefts, both inside and outside the cleft region, and the possible association between the side of the cleft and the side of the missing teeth were studied using radiographs of 278 patients with cleft lip, cleft palate, or both (158 boys and 120 girls), age 5 to 18 years (mean age 10.4 years). A hypodontia prevalence of 77% (excluding third molars) was found for the total cleft sample. This was significantly higher, both statistically and clinically, than the incidence of hypodontia reported for noncleft populations, and considerably higher than the prevalence reported in other studies of children with clefts. The maxillary permanent lateral incisors were the teeth most frequently missing on the cleft side (259 teeth) followed by the maxillary (47 teeth) and mandibular (23 teeth) second premolars, in both boys and girls. The teeth that were most often missing on the noncleft side were the maxillary second premolars (12 teeth), followed by the maxillary lateral incisors (10 teeth) and mandibular second premolars (6 teeth). Hypodontia of both the maxillary lateral incisors and second premolars was found more frequently on the left side, which also has a higher frequency of clefting.     

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.     

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.     

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。     

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.     

Pattern of tooth loss in a selected population in Greece

The pattern of tooth loss with age for individual teeth was examined in a selected population. The survey covered patients attending the Dental School of Athens University. Tooth loss increased steadily with age and was higher for the periodontitis than the gingivitis group. Mortality of individual teeth was analyzed for each type of tooth within the maxillary pair and within the mandibular pair and no statistical significance was found. The statistically highly significant differences in loss rates within most groups of four teeth were clearly attributable to differences between the maxilla and mandible. For the permanent second molars differences in loss were close to the significance level while for the first molars the difference was statistically highly significant. A statistically significant difference was found between losses of the four second premolars while highly significantly differences were noticed between first premolars. Mortality for canines was low, but differences in losses were highly statistically significant. The two mandibular incisors had the lowest rates of loss in our sample, difference in loss between maxillary and mandibular incisors was statistically highly significant. Central incisors had a similar pattern of loss to that of lateral incisors but differences in loss rates were not statistically significant.     

Long-term effect of root proximity on periodontal health after orthodontic treatment

The present investigation was done to evaluate the incidence and distribution of root proximity after orthodontic treatment and to test the hypothesis that interproximal areas with thin interdental bone provide less resistance against marginal periodontal breakdown than areas with normal width of bone between the roots. Only adult patients were examined at least 16 years after active orthodontic treatment. The distance between the roots was measured directly on periapical radiographs. Gingival health, level of connective tissue attachment, and clinical scores for bone levels in sites with thin interdental bone and neighboring or contralateral sites with normal width of bone between the roots were compared. Among the 400 patients studied, 25 had unilateral or bilateral areas with root proximity. Root proximity was diagnosed between maxillary central and lateral incisors in 18 patients, between mandibular central and lateral incisors in two patients, and between maxillary lateral incisor and canine, maxillary first and second molars, mandibular canine and first premolar, mandibular first and second premolars, or mandibular first and second molars in only one patient. No statistically significant differences in inflammation, level of attachment, and bone level were observed between root proximity sites and control sites. The results indicate that anterior teeth are not predisposed to more rapid periodontal breakdown when roots are in close proximity. Too few molar sites were included to draw conclusions regarding such areas.     

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.     

A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population

Objectives

We aimed to determine the prevalence and distribution of root dilaceration by tooth type and to investigate the relationship between trauma history and teeth with dilaceration in a large population of adult dental patients in Turkey.

Methods

Periapical radiographs of 9,406 permanent teeth from 5,504 patients were examined. Teeth were recognized as having mesial or distal root dilaceration if there was deviation of 90° or more from the normal long axis of the tooth. The patients’ biographic data, dilacerated and non-dilacerated teeth, and accidental trauma history were recorded. The Pearson Chi-square test was used to evaluate differences by sex and the Mann–Whitney U test was used to determine whether significant differences existed in the occurrence of dilaceration by age and side.

Results

In the 5,504 subjects (2,877 males and 2,627 females), 9,406 teeth (5,029 in males and 4,377 in females) were examined. The Mann–Whitney U test revealed no significant differences in root dilacerations by age (P = 0.6) The teeth most frequently observed with root dilaceration were mandibular third molars (10.7 %), followed by maxillary first molars (5.8 %), mandibular second molars (5.2 %), maxillary third molars (5.0 %), maxillary second molars (4.9 %), and mandibular third molars (4.9 %). Overall, there were 161 right and 156 left root dilacerations. In all patients, the root dilacerations were unilateral. Trauma occurred in 1 % (n = 59) of the population, and all cases were in the maxillary arch. Trauma involved 0.6 % of all teeth examined, and was most common in maxillary third molars (2.6 %), followed by maxillary first molars (1.9 %), maxillary second molars (1.3 %), and maxillary lateral incisors (1.3 %) (P > 0.05). In 252 of 317 dilacerated teeth (79 %), the dilaceration was observed in the apical third region.

Conclusions

Clinicians should consider the possibility of root dilaceration in teeth with trauma history. When other treatment (such as extraction, orthodontics) is required, identification of a dilaceration is important to ensure appropriate management. Periapical radiographs are the most appropriate way to diagnose the presence of root dilacerations.     

Tooth anomalies associated with failure of eruption of first and second permanent molars

The occurrence of tooth anomalies in association with failure of the first and second molars to erupt was assessed in a sample of 1520 nonsyndromic subjects with uncrowded dental arches (mean age, 14 years 4 months) and compared with the prevalence rate calculated in a matched control group of 1000 subjects. The tooth anomalies examined included infraocclusion of deciduous molars, palatal displacement of maxillary canines, rotation of maxillary lateral incisors, aplasia of second premolars, and small size of maxillary lateral incisors. Associations among arrested eruption of first and second permanent molars and anomalies in tooth eruption and position (infraoccluded deciduous molars, palatally displaced canines, rotated maxillary lateral incisors) were highly significant (P <. 001). No significant association was found among the occurrence of molar eruption disturbances, aplasia of premolars, and small-sized laterals. These findings point to a common biologic cause for the appearance of failure of eruption of molar teeth and other disturbances in tooth eruption and position, most likely under genetic influence.     

Mesiodistal tooth size in non-syndromic unilateral cleft lip and palate patients: a meta-analysis

Objectives

To evaluate, using meta-analysis methodology, mesiodistal tooth dimensions in non-syndromic unilateral cleft lip and palate (CLP) patients.

Materials and methods

A literature search was conducted using PubMed, Medline, Google Scholar Beta, EMBASE Excerpta Medica, CINAHL, Web of Science, and the Cochrane Collaboration, identifying English and non-English articles reporting on mesiodistal tooth dimensions on the cleft and non-cleft side of non-syndromic unilateral CLP patients. Additional studies were identified by searching reference lists of articles consulted. Only studies with a suitable control group were included. Two examiners independently performed the literature search and data extraction. Using meta-analysis software, data extracted from each selected study were statistically combined using the fixed-effects model. Weighted mean differences, 95 % confidence intervals, and heterogeneity were calculated for each measurement.

Results

Four articles fulfilling the inclusion criteria were located and included in the meta-analysis. Maxillary incisors and first molars were found to be significantly larger on the non-cleft side while mandibular incisors and premolars were larger on the cleft side, in non-syndromic unilateral CLP patients. On the cleft side, maxillary premolars and second molars were larger in cleft than control patients while incisors were smaller, whereas all mandibular teeth were larger in cleft patients. On the non-cleft side, all maxillary teeth except for the central incisors were larger in the cleft than control patients, while all mandibular teeth were larger in the cleft patients except for lateral incisors.

Conclusions

Non-syndromic unilateral CLP patients tend to have larger posterior but smaller anterior teeth compared with the general population. Comparing sides, unilateral CLP patients tend to have smaller maxillary but larger mandibular teeth on the cleft than on the non-cleft side.

Clinical relevance

Given that obtaining a stable, functional, and esthetic occlusion requires a thorough evaluation of tooth size, knowledge about trends in tooth size variations in CLP patients can help with dental and orthodontic treatment planning.     

Trends in orthodontic management strategies for patients with congenitally missing lateral incisors and premolars

ObjectivesTo identify changes in orthodontic management strategies in patients with hypodontia seen in 2000, 2010, and 2017/2018 (during a 1-year period).Materials and MethodsAn assessment of the panoramic radiographs of 3701 patients from a Western Australian private practice identified 276 individuals demonstrating hypodontia. The location of missing teeth, age, sex, type of malocclusion, and the management strategies (space closure or opening) for each patient were noted.ResultsMost hypodontia involved agenesis of three or fewer teeth (90%). Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. Female preponderance was noted. When considering treatment, the odds ratio for orthodontic space opening and prosthetic replacement in 2000 was 3.266 (P value = 7e-04; 95% confidence interval [CI], 1.464–4.633) compared with patients seen in 2010 and 1.632 (P value = 7e-04; 95% CI, 0.811–2.434) compared with patients in 2017/2018. For patients demonstrating bilateral absence of maxillary lateral incisors, the odds ratio for orthodontic space opening was 3.185 (P value = 0.0215; 95% CI, 1.182–9.243) compared with counterparts with unilateral agenesis. None of the factors investigated were significantly associated with the types of treatment planned/provided for the patients with missing mandibular second premolars.ConclusionsMaxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. A trend away from space opening and prosthetic replacement toward orthodontic space closure was observed from 2000 to 2017/2018. This may reflect a change in attitude toward prosthetic replacement options and/or greater optimism with biomechanical strategies since the implementation of temporary anchorage devices to assist in space closure.