Congenitally missing maxillary primary canines: report of three cases

BACKGROUND: Hypodontia is uncommon in the primary dentition and lateral incisors are the most commonly missing primary teeth in the patients affected. Studies have found that hypodontia in the primary dentition involving only maxillary canine is rare. CASE REPORTS: Three cases of hypodontia in the primary dentition involving only maxillary canine are presented. Two of them were affected by hypodontia and hyperdontia in the permanent dentitions respectively, yet all the permanent canines developed normally in these three cases. CONCLUSION: In children with congenitally missing maxillary canines, the permanent dentitions may show diverse anomalies in tooth numbers, ranging from hypodontia to hyperdontia.     

Maxillary lateral incisors of subjects with cleft lip and/or palate: Part 2.

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenitally absent (p less than .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenitally. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.     

Case report: autotransplantation for a missing permanent maxillary incisor

Patients with nonrestorable or missing anterior teeth are typically seen by their general or pediatric dentist who directs the course of consultation, referral, and treatment. In the mixed dentition stage, loss of permanent maxillary incisors is usually treated by various forms of removable/fixed prosthetic appliances. Because premolars are developing during this time period, transplantation of an available premolar to an incisor position is a viable alternative, that may provide a better biological substitute for a missing incisor than other choices. The purpose of this case report was to describe the treatment of the loss of a permanent maxillary central incisor by transplantation of a maxillary first premolar to the incisor position. Autotransplantation allowed normal alveolar bone development and a future option of permanent restoration without implants or partial dentures. Autotransplantation should be given consideration as a reasonable option for the treatment of missing incisors in mixed dentition.     

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．     

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.     

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。     

Anomalies of deciduous teeth and findings in permanent dentition]

Prevalence of anomalies of deciduous teeth has been analyzed in the general population of Zagreb preschool children. The sample comprised 2,987 children from 3 to 6 years of age (1,582 boys and 1,405 girls). Hypodontia was found in 0.47%, hyperdontia in 0.10%, and double teeth in 0.43% of total sample. Total prevalence of all anomalies in the sample was 1.0%. The sample for the analysis of permanent dentition has been enlarged with the clinical sample of children having the same anomalies and comprised 48 children. In all children with anomalies of primary teeth the orthopantomograms were taken and the status of permanent dentition was analyzed. In children with hypodontia in primary dentition hypodontia of permanent teeth was found in 100% of cases. Patients with hyperdontia of primary teeth displayed anomalies in permanent dentition in 85.7%, while in children with primary double teeth, anomalies of permanent teeth were present in 61.1% of cases. Missing deciduous teeth were found in both jaws in only 8.7% of cases, and in 34.8% in permanent dentition. Symmetrical occurrence of hypodontia of primary teeth (i.e. in both sides of jaws) was significantly higher in boys (56.3%) than in girls (28.6%). In permanent dentition symmetrical occurrence of hypodontia was significantly higher than in primary dentition (81.3% in boys and 57.1% in girls). The most frequently missing primary teeth were maxillary lateral incisors (48.8%) followed by mandibular central incisors (34.9%). Hyperdontia of primary teeth has been found only in boys, and it related only to the maxillary lateral incisors. Anomalies of deciduous teeth show a high degree of association with the finding in the permanent dentition.(ABSTRACT TRUNCATED AT 250 WORDS)     

The craniofacial morphology of individuals with hypodontia

This work describes the variations in craniofacial morphology in individuals with congenially missing permanent teeth with relation to facial prognathism, jaw development and inclination of the incisor teeth. Both sexes displayed significantly less upper jaw prognathism in individuals with hypodontia compared to the controls, and a less maxillary length as well. This finding was independent of whether the congenitally missing teeth were situated in the upper or the lower jaw. The upper incisors displayed greater anterior inclination in the individuals with hypodontia of both sexes.     

Ectopic eruption of permanent incisors after predecessor pulpectomy: five cases

Pulpectomy in primary teeth is a common technique that preserves teeth in the oral environment and maintains or recovers periapical tissues to a healthy condition. This article describes the ectopic eruption of permanent incisors whose primary predecessors underwent pulpectomy using ZOE filler paste. In a group of 135 teeth that received pulpectomy therapy due to caries, 10 primary maxillary incisors had overretention and were followed for at least 3.5 years (mean time of 4.2 years), both clinically and radiographically, until the permanent teeth erupted. The proposed treatment included extraction of the overretained primary incisors based on permanent successor eruption chronology and contralateral eruption. Seven permanent teeth erupted ectopically. Autocorrection of the permanent tooth positions was observed in five cases. It can be concluded that periodic clinical and radiographic assessments are essential to verify radicular and filling paste resorptions and to avoid overretention and any subsequent malocclusion.     

Management of supplemental permanent maxillary lateral incisors in association with talon cusp on the primary predecessors: a report of 3 cases

Most of the cases of talon cusp in the primary dentition affected the maxillary central incisors, but have no effect on the permanent successors. Among the 5 cases of a talon cusp in primary maxillary lateral incisors reported in the dental literature, however, one was associated with a supernumerary tooth and 3 with supplemental permanent successors. The purpose of this report was to describe 3 cases of a talon cusp on the primary maxillary lateral incisors of Chinese children, all of which were associated with talon teeth or the permanent successors. A conservative approach was used to manage these supplemental permanent lateral incisors, and the advantages of such an approach are discussed.     

Gingival contour and clinical crown length: their effect on the esthetic appearance of maxillary anterior teeth

Fractured, congenitally missing, or avulsed maxillary incisors can often jeopardize the esthetic appearance of the remaining maxillary anterior teeth after orthodontic treatment. In many cases the unesthetic appearance is related to the irregular clinical crown lengths of either the fractured teeth or those that have been substituted for the missing teeth. The results of five cases with either fractured or traumatically avulsed central incisors are reported. Selective tooth intrusion and restorative techniques were used during the finishing stages of orthodontic treatment to improve the final esthetic result. The advantages and disadvantages of the intrusion technique are discussed.     

The relationship between a primary maxillary incisor with a talon cusp and the permanent successor: a study of 57 cases

BACKGROUND: Most reported cases of talon cusps in the primary dentition have been on the maxillary central incisors and the permanent successors have remained unaffected. Four of the five reported cases on a maxillary lateral incisor, however, have been associated with a supernumerary permanent successor. AIM: This paper describes the relationship between the presence of talon cusps on a primary maxillary incisor, and the morphology and number of the permanent successors in a population of Chinese children. DESIGN: The dental records of children diagnosed with a talon cusp on a primary incisor were retrieved for review. The diagnoses took place in a regional school dental clinic in Hong Kong between April 2002 and August 2005. RESULTS: Fifty-eight primary maxillary incisors with talon cusps were found. When the central incisors were involved, 32 of the 35 (91.4%) underlying permanent successors were not found to be associated with any odontogenic abnormalities. When the lateral incisors were involved, however, 18 of the 23 cases (78.3%) showed odontogenic abnormalities, 14 of which were associated with supernumerary teeth. CONCLUSIONS: The present study shows that, when there is a talon cusp on a primary maxillary lateral incisor, a high proportion of the underlying permanent successors can be expected to exhibit odontogenic abnormalities.     

Eruption disturbances in Japanese children and adolescents

The aims of this report were to determine the nature of eruption disturbances and to establish the pattern of management for these teeth in a group of Japanese children and adolescents. Data were collected from the clinical records of patients in the Pediatric Dental Clinic of Niigata University Medical and Dental Hospital. There were 700 patients (364 males and 336 females) and 748 teeth (26 primary teeth and 722 permanent teeth) who were treated for eruption disturbances between 1979 and 2002. During this period, 17,365 new patients visited the clinic, of whom approximately 4% had eruption disturbances. The most frequently affected permanent teeth were the maxillary central incisors (38.6%), followed by the maxillary canines (15.4%). Of the permanent teeth, 52.5% were in males and 47.5% in females. Although there were more cases of maxillary central incisors in males than in females, the number of cases involving maxillary canines was higher in females. Whereas delayed eruption was noted in 76.7% of maxillary central incisors, 18.6% were impacted and 4.7% demonstrated abnormal direction/position which required treatment. In contrast, a higher percentage (64.8%) of maxillary canines that showed abnormal direction/position was treated. Eruption disturbances were found in 40% of the patients during routine examinations. This suggests that regular routine examinations are important for pediatric dentists to detect and treat eruption disturbances early.     

An audit of concomitant dental anomalies with maxillary talon cusps in a group of children from Hong Kong

AIM: To investigate the prevalence of various concomitant dental anomalies in Hong Kong children with true talon cusps on the permanent maxillary incisors. METHODS: Dental records and radiographs of a group of Hong Kong Chinese primary schoolchildren with true talon cusps (half crown height or more) on one or more permanent maxillary incisors were selected and studied retrospectively. The prevalence of various dental anomalies in this group of children was compared with that of the general population of Hong Kong Chinese children of similar age. RESULTS: A total of 11,537 records were reviewed and 58 children with true talon cusps on one or more permanent maxillary incisors were identified. A total of 69 permanent maxillary incisors were affected, of which all except one were lateral incisors. Dens evaginatus on premolars, supernumerary teeth in the anterior maxilla, and hypodontia were found in 5 (8.6%), 5 (8.6%), and 5 (8.6%) cases respectively. The prevalence of supernumerary teeth was significantly higher in children with true talon cusps as compared with the results of two previous general studies of Chinese children of similar age (P<0.05, Fisher's exact test). CONCLUSION: Children with true talon cusps on the permanent maxillary incisors were more frequently affected by supernumerary teeth in the anterior maxilla. Further studies with a larger sample are needed to confirm a true association.     

328颗上颌恒切牙异常萌出原因的临床分析

目的分析导致上颌恒切牙异常萌出的原因,为提高诊疗水平提供理论依据。方法收集上颌恒切牙异常萌出的患者239例,共计328颗上领恒切牙,记录并分析导致上颌恒切牙异常萌出的原因,对数据进行统计学分析。结果328颗异常萌出的上颌恒切牙中,阻生或弯曲牙者64颗;上颌恒切牙已萌出,但位置异常者264颗,其中唇侧异常萌出45颗,腭侧异常萌出187颗,远中异常萌出32颗。对异常萌出的原因进行分析,上颌乳前牙根尖感染患者92例（38．5％）,上颌乳前牙外伤患者30例（12．6％）,上颌乳前牙滞留患者（非感染和外伤所致）26例（10．9％）,多生牙患者18例（7．5％）,上唇系带肥厚患者11例（4．6％）,口腔不良习惯、骨量不足等其它原因患者19例（7．9％）,另有43例（18．0％）患者合并局部或全身多种相关疾病。结论乳前牙根尖周炎是导致上颌恒切牙异常萌出的主要病因,儿童口腔医生应积极治疗乳牙疾病,去除或减轻导致上颌恒切牙异常萌出的因素,诱导儿童牙列和咬合功能的正常发育。     

Prevalence of abnormalities in dental structure, position, and eruption pattern in a population of unilateral and bilateral cleft lip and palate patients.

OBJECTIVE: To evaluate the dental characteristics of patients subjected to a protocol that included early secondary gingivoalveoloplasty (ESGAP). DESIGN: Panoramic radiographs of 87 patients with unilateral cleft lip and palate (UCLP) and 29 with bilateral cleft lip and palate (BCLP) were evaluated. Missing and supernumerary teeth were also quantified on the cleft and noncleft side and in the maxilla and mandible. Crown and root malformations and tooth rotations were quantified. A subsample in permanent dentition was extrapolated to analyze canine eruption patterns. RESULTS: A total of 48.8% of the UCLP patients presented with missing permanent lateral incisors in the cleft area and 6.1% contralaterally. A total of 4.9% presented with missing second maxillary premolars on the cleft site and 1.2% contralaterally. A total of 7.3% presented with supernumerary lateral incisors, and 45% of the BCLP cleft sites presented with missing lateral incisors, while 25% of the cleft sites presented second maxillary premolars agenesis. Five percent of the cleft sites presented with supernumerary lateral incisors. Evaluation of the subsample in permanent dentition showed that 15.5% had a canine retention and 4.4% of the canines had to be surgically exposed. A significant association was observed between canine inclination and retention but not with absence of the lateral incisor. CONCLUSIONS: The frequency of dental anomalies in this sample was similar to other cleft populations. As surgical trauma has been suggested to damage forming teeth, the results of this study indicated that ESGAP has no detrimental influence on subsequent dental development.     

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.     

Talon cusp in the primary dentition: literature review and report of three rare cases

This paper reviews the nomenclature, prevalence, definition, etiology, association with other dental/anomalies, diagnosis and treatment planning of talon cusp in the primary anterior teeth. Most of the reported cases have involved the primary maxillary central incisors. However, talon cusps on the primary maxillary lateral incisors are associated with high percentages of anomalies in the permanent successors. This paper reported three such rare cases and dentists should be aware of such additional anomalies.     

An unusual distribution of supplemental teeth in the primary dentition

Supernumerary teeth are more common in the permanent than the primary dentition. In the latter, the majority occur in the maxillary lateral incisor region or as a mesiodens. Indeed, in one study conducted in the USA, all 26 cases of primary supernumerary teeth examined were found to be lateral incisors. This report describes a case presenting with three erupted supernumerary (supplemental) teeth in the primary dentition, including, somewhat unusually, bilateral duplication of maxillary canines.