Unusual sequelae of a subluxated primary incisor on its permanent successor tooth

Traumatic dental injuries (TDIs) such as subluxations of primary teeth can have significant consequences on their developing successors. The purpose of this report is to present a 3‐year‐old boy who encountered subluxation injuries to his primary incisors which subsequently had an unusual consequence on the permanent successor. On the day of the TDI, based on clinical and radiographic examinations, a diagnosis of subluxation of teeth 52, 51 and 61 was made. By age 5, the patient reported that tooth 51 had exfoliated, and consequently, tooth 11 had erupted into the oral cavity, but it was very loose. Eventually, the patient lost the crown of tooth 11 during his routine daily activities. Furthermore, radiographic examination at age 11 revealed a small root‐like structure in the tooth 11 region. It is very unusual to have premature loss of a permanent incisor following subluxation to its predecessor. Therefore, the present case serves as a good example to emphasize that even minor TDIs are of considerable importance as they may lead to unexpected consequences.     

Characteristics of premaxillary supernumerary teeth in primary and mixed dentitions: a retrospective analysis of 212 cases

Abstract Aim: To investigate the characteristics and distribution of premaxillary supernumerary teeth affecting primary and mixed dentitions in Indian children. Methods: This retrospective analysis included 11 200 children, aged 3–12 years, who attended a pediatric dental clinic for dental care during the period 2007–2010. The children were divided into group I (aged 3–6 years) and group II (aged 7–12 years), and data regarding maxillary anterior supernumerary teeth, diagnosed both as isolated and/or as unexpected findings during routine clinical and radiological examinations, were gathered. Pearson’s χ²‐test, with a 0.05 level of significance, was used for the analysis. Results: The overall prevalence of premaxillary supernumerary teeth in primary and mixed dentitions was 1.9%. Single supernumerary teeth (84.9%) and conical morphology (68.7%) were commonly seen in both groups. The most common sagittal position was palatal (92.3%) among both erupted and impacted maxillary anterior supernumerary teeth. Conclusion: The prevalence of premaxillary supernumerary teeth in Indian children found in this study was 1.9%, with an overall male to female ratio of 1.7:1. Single supernumerary teeth, conical morphology, and erupted supernumerary teeth were the most commonly seen. Supernumerary teeth associated with clinical complications were relatively low (48%), and axial rotation or displacement of maxillary incisors was the most common sequelae.     

Supernumerary tooth in the primary molar region: a case report

Supernumerary teeth are among the most common dental anomalies affecting the primary and permanent dentition. They are usually found in the anterior maxilla and occur infrequently in the primary dentition. The purpose of this paper was to report a case diagnosed with primary supernumerary tooth in the primary second molar region. The crown and root shape of the primary supernumerary tooth resembled that of the primary first molar. On radiographic examination, the primary supernumerary tooth was followed by a permanent supernumerary successor with an unusually big crown. The primary supernumerary molar was immediately extracted to avoid interference with the development of the second premolar's tooth bud. This dental anomaly is rarely observed, as only primary supernumerary teeth in the anterior region have been reported in the dental literature.     

Aetiology and risk factors related to traumatic dental injuries – a review of the literature

Abstract – Background/Aim: During the past 30 years, the number of aetiologies of traumatic dental injuries (TDIs) has increased dramatically in the literature and now includes a broad spectrum of variables, including oral and environmental factors and human behaviour. The aim of this study is to present an international review of well‐known as well as less well‐known unintentional and intentional causes of TDIs. Moreover, some models that are useful in investigating contact sport injuries are presented. Materials and methods: The databases of Medline, Cochrane, Social Citation Index, Science Citation Index and CINAHL from 1995 to the present were used. Result: Oral factors (increased overjet with protrusion), environmental determinants (material deprivation) and human behaviour (risk‐taking children, children being bullied, emotionally stressful conditions, obesity and attention‐deficit hyperactivity disorder) were found to increase the risk for TDIs. Other factors increasing the risk for TDIs are presence of illness, learning difficulties, physical limitations and inappropriate use of teeth. A new cause of TDIs that is of particular interest is oral piercing. In traffic facial injury was similar in unrestrained occupants (no seat belts) and occupants restrained only with an air bag. Amateur athletes have been found to suffer from TDIs more often than professional athletes. Falls and collisions mask intentional TDIs, such as physical abuse, assaults and torture. Violence has increased in severity during the past few decades and its role has been underestimated when looking at intentional vs unintentional TDIs. There are useful models to prevent TDIs from occurring in sports. WHO Healthy Cities and WHO Health Promoting Schools Programmes offer a broad solution for dental trauma as a public health problem. Conclusion: The number of known causes of TDIs has grown to alarming levels, probably because of increased interest of the causes and the underlying complexity of a TDI. Accepted oral, environmental and human aetiological factors must therefore be included in the registration of TDIs.     

Epidemiology of traumatic dental injuries – a 12 year review of the literature

Abstract – Background/Aim: A traumatic dental injury (TDI) is a public dental health problem because of its frequency, occurrence at a young age, costs and that treatment may continue for the rest of the patient’s life. The aim of this paper is to present a12‐year, international review of the prevalence and incidence of TDIs including some background factors and a quick, easy method in registering TDIs to receive a primary understanding of the extent and severity of dental trauma. Material and method: The databases of Medline, Cochrane, SSCI, SCI and CINAHL from 1995 to the present were used. Result: The results indicate a high prevalence of TDIs in primary and permanent teeth and that TDIs exists throughout the world. The prevalence show that one third of all preschool children have suffered a TDI involving the primary dentition, one fourth of all school children and almost one third of adults have suffered a trauma to the permanent dentition, but variations exist both between and within countries. Activities of a person and the environment are probably more determining factors of TDIs than gender and age. A risk profile why some patients sustain multiple dental trauma episodes (MDTE) is necessary to present. All dental clinics should have a prospective ongoing registration of TDIs. The NUC method (N = no TDI, U = uncomplicated TDI, C = complicated TDI) presents if there has been any TDI and the severity of that trauma. Conclusion: The trend of TDIs seems to be stable on a high level with variations largely reflecting local differences. Because of the complexity of TDIs, every dental clinic should have a prospective ongoing registration of number and severity of TDIs.     

A case report of cleidocranial dysplasia: A noninvasive approach

Cleidocranial dysplasia (CCD) is a rare bone disorder. The main dental features are the presence of multiple retained deciduous teeth and supernumerary teeth, as well as unerupted permanent teeth. To date, CCD is managed by a combination approach, which consists of the extraction of deciduous and supernumerary teeth, followed by orthodontic traction of unerupted permanent teeth. This case highlights the management of a girl with CCD, who refused the recommended protocol. A 15‐year‐old Malay female presented with a complaint of retained deciduous teeth. Intraoral examination revealed multiple retained deciduous teeth. Radiographs showed numerous impacted supernumerary and unerupted permanent teeth. The patient opted to improve her facial appearance with a less aggressive treatment option. A composite build‐up on all anterior maxillary deciduous teeth was carried out until the patient was ready to undergo surgical intervention.     

Critical appraisal of the 2020 IADT Guidelines: A personal commentary

The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for—(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth—have sufficient evidence to support the changed recommendations.     

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.     

Traumatic dental injuries of permanent incisors in 11- to 13-year-old South African schoolchildren

Abstract –  Traumatic dental injuries (TDI) are common in children. There are few data on prevalence of TDI in South African populations. We assessed the prevalence and causes of TDI to anterior teeth in 11- to 13-year-old South African schoolchildren through a cross-sectional study, using a random cluster sampling method. Oral examinations were performed by calibrated examiners following training for TDI to anterior permanent incisor teeth (eight teeth) using a modified version of Ellis's classification. Of the study population of 2610 children aged 11–13 years old from 26 primary schools, 1665 children participated. The response rate was 64%. More than two-thirds (64.4%) were 12 years old. One hundred and six children had a TDI (6.4%). After adjusting for the effect of age and socio-economic status, boys had an almost 2.5 (95% CI: 1.59, 3.69) times higher probability of having a traumatic dental injury than girls. The highest prevalence was in 12 year olds and in the high socio-economic status group. Most of the children had trauma to one tooth. Enamel fracture was the main type of TDI (69.1%). The majority of the TDIs were untreated (85.4%). Homes and schools were the most common places where TDIs occurred, while only 5.7% occurred on a street, road or pavement. Falls were the main cause of TDIs. Sport was the second most common cause and the third most common cause was collision with objects. The present study indicates that the prevalence of TDIs in schoolchildren is not as high as has been reported in other countries. The prevalence of TDIs in this population was relatively low.     

Dentigerous cyst formation following trauma to the primary incisors: A case report

Although usually considered to be of developmental origin, dentigerous cysts (DCs) have been reported to form in response to chronic periapical inflammation associated with primary teeth that have necrotic, infected pulps. This article describes the management of a DC associated with tooth 21 in a seven-year-old Caucasian child with a history of multiple TDIs to the primary maxillary incisors. Chronic periapical inflammation associated with a necrotic pulp in tooth 61 was identified as the likely cause of the lesion. Initial conservative management involved marsupialization of the lesion by extracting the necrotic tooth 61. Following significant decompression of the cyst, surgical enucleation was carried out under general anaesthesia and an orthodontic attachment was bonded to the crown of the unerupted tooth 21 to facilitate traction. Histopathological assessment of the enucleated tissue confirmed it to be a DC. Two years after the initial presentation, teeth 21 and 22 had erupted into the oral cavity, improving patient aesthetics. However, the root of tooth 22 was transposed with the crown of the unerupted tooth 23. This case highlights the undesirable sequelae that may occur following delayed and inappropriate management of TDIs.     

Triad of bilateral duplicated permanent teeth, persistent open apex, and tooth malformation: a case report

AIM: The aim of this article is to report a case of bilateral multiple impacted supernumerary teeth. A discussion of possible mechanisms of development is also presented along with a concise review of the literature. BACKGROUND: Supernumerary teeth occur in the context of various scenarios in the primary and the permanent dentition. Multiple supernumerary teeth are a rare finding especially in the absence of associated syndrome or disease. REPORT: A case of bilateral multiple impacted supernumerary teeth localized to the mandibular premolar region is reported. Some of the supernumerary teeth as well as the erupted premolars had persistent open apices. Coronal malformation of the right maxillary first premolar was another interesting finding. There was an absence of any concomitant disease. SUMMARY: The aforementioned combination of findings has not been reported previously. The anatomical, geometrical, and spatial relationships of supernumerary teeth with their erupted equivalents may shed light on some controversial aspects of the etiology.     

Bilateral maxillary and mandibular fourth molars: a case report and literature review

Supernumerary teeth are those present in addition to the normal set of teeth. These teeth are found in both the primary and the permanent dentitions, and are most frequently seen in the maxillary anterior and molar regions. Supernumerary molars are divided into two types, depending on their location: distomolars and paramolars. Distomolars usually occur in the form of a fourth molar distal to the third molar, while paramolars are rudimentary supernumerary teeth that might develop buccally or lingually to the molar series. The management of a supernumerary tooth should be part of a comprehensive treatment plan. This paper reports a rare case of a male patient with bilateral maxillary and mandibular fourth molars, and reviews the literature on supernumerary teeth.     

Work‐related traumatic dental injuries: Prevalence,characteristics and risk factors

Background/Aims

The prevalence of work‐related oral trauma is underestimated because minor dental injuries are often not reported in patients with several injuries in different parts of the body. In addition, little data are available regarding their characteristics. The aim of this epidemiological study was to determine the prevalence, types, and characteristics of occupational traumatic dental injuries (TDIs) in a large working community.

Materials and Methods

Work‐related TDIs that occurred during the period between 2011 and 2013 in the District of Genoa (Northwest of Italy, 0.86 million inhabitants) were analyzed. Patients’ data were obtained from the National Institute for Insurance against Accidents at Work database.

Results

During the 2 year period, 112 TDIs (345 traumatized teeth) were recorded. The prevalence was 5.6‰ of the total amount of occupational trauma. The highest prevalence was found in the fourth and fifth decades of life (OR=3.6, P < .001), and males were injured more often than females (70.5% vs 29.5%, OR=2.8, P < .001). Service and office workers represented 52% of the sample, and construction/farm/factory workers and craftsmen were 48%. TDIs involved only teeth and surrounding tissue in 66% of cases, or in combination with another maxillofacial injury in 34%. They were statistically associated with construction/farm/factory workers group (Chi squared P < .01). Crown fracture was recorded in 34.5% of cases, subluxation/luxation in 10.7%, avulsion in 9%, root fracture in 3.8%, and concussion in 3.5%. Thirty‐two subjects (28.6%, 133 teeth, OR=4.3, P < .001) presented at least 1 traumatized tooth with previous dental treatment. Among 212 (61.4%) traumatized teeth, 67.5% were upper incisors, 17.5% were lower incisors, 3.3% were upper canines, 1.9% were lower canines, and 9.9% were bicuspids and molars.

Conclusions

Work‐related TDIs had a low overall prevalence, and fractures were the most frequent dental injury. Age, gender, and preexisting dental treatments represented risk factors for work‐related TDIs.     

Development of the dentition in cleidocranial dysplasia

The purpose of the present investigation was to describe the formation, maturation and eruption of the dentition, including supernumerary teeth in a sample of patients with cleidocranial dysplasia. The dentition was evaluated from orthopantomograms, intraoral radiographs, cephalometric films, surgically removed teeth and intraoral photographs in 19 patients (9 men, 10 women), aged 3.5 to 34 years. Formation of primary teeth was normal, whereas all patients but one had supernumerary permanent teeth. Frequency of supernumerary teeth ranged from 22% in the maxillary incisor region to 5% in the molar regions. Supernumerary teeth were formed lingually and occlusally to the normal teeth. Maturation of the primary dentition was normal, while permanent teeth were delayed from 1 to 4 yr. Supernumerary teeth were delayed about 4 years in relation to normal permanent teeth. Eruption of primary teeth was normal, whereas all patients had severe eruption problems of permanent teeth. It was hypothesized that the dental lamina for both primary and permanent dentition is normal, but does not resolve completely and therefore may form supernumerary teeth. Abnormalities of tooth morphology is related to inadequate space and arrested eruption. Delayed or arrested eruption is probably caused by diminished resorption of bone and of primary teeth and to the presence of multiple supernumerary teeth.     

Supernumerary teeth in the primary dentition: a report of two cases

Supernumerary teeth occur frequently in the permanent dentition, but they are rare in the primary dentition. Mesiodens is a supernumerary tooth with a cone shaped crown and a short root. The supernumerary tooth which bears resemblance to the tooth with which it is associated is called a supplemental tooth. The etiology of supernumerary teeth is still unknown and not well understood. Radiographic examination of pre-school children is essential for their diagnosis. Early removal of these teeth is required so that complications such as delay in eruption of permanent teeth, crowding, diastema, rotations and certain pathologic conditions can be averted.     

Multiple supernumerary teeth in two brothers: a case report

Supernumerary teeth (hypersontia) are relatively common in the general population and occur more frequently in patients with a family history of such teeth. Supernumerary teeth have been reported in many genetic syndromes, but multiple supernumerary teeth occurring as an isolated non-syndromic trait are rare. This article describes a rare non-syndromic variety of multiple impacted supernumerary teeth in two brothers.     

Radiographic diagnosis of supernumerary premolars: case reviews

The literature reported prevalence of supernumerary teeth within the mandible and maxilla varies from 0.2-0.9%. This study reviews the formation and diverse clinical appearances of supernumerary premolars. We present case reports where supernumerary teeth were recognized as incidental findings during routine radiographic examination in patients with an age range of five to thirty-nine years. Cases are presented to illustrate that the initiation and development of supernumerary premolars are often delayed by a magnitude of years. Periodic examination is recommended for occurrence and clinical behavior. In the presented cases, displacement and resorption of the adjacent teeth was not evidenced. None of the supernumerary teeth demonstrated cystic transformation. The importance of differential radiographic diagnosis is discussed.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented.     

Tooth abnormalities and soft tissue alterations in patients with G/BBB syndrome

Objective: The G/BBB syndrome is an X‐linked recessive disorder characterized by eye anomalies, laryngotracheoesophageal cleft, congenital heart disease, genitourinary anomalies and gastrointestinal disorders. Patients may also present cleft lip and palate, high‐arched palate and thin upper lip. This study aimed to investigate the occurrence of tooth abnormalities and soft tissue changes in patients with G/BBB syndrome. Design: Cross‐sectional. Subjects and methods: Twenty‐one patients with G/BBB syndrome were analyzed as to the presence of tooth abnormalities and soft tissue alterations. Main outcome measures: The prevalence of tooth agenesis and supernumerary teeth was compared to patients without morphofunctional alterations, matched for gender and age. Results: All patients had complete cleft lip and palate; 95.23% of patients presented tooth abnormalities, mainly hypoplastic alterations, with predominance of alterations of number, followed by alterations of structure, shape and position. The frequency of tooth agenesis and supernumerary teeth was significantly higher compared with the control group; 11 patients presented incisiform supernumerary teeth in the mandibular anterior region. Ankyloglossia was observed in 11 of 21 patients. Conclusion: The presence of mandibular anterior supernumerary teeth and ankyloglossia should be investigated in the clinical evaluation of patients with suspected diagnosis of the G/BBB syndrome.     

Non-syndrome multiple supernumerary teeth: A case report

AIM: The purpose of this case report is to present a case of a non-syndrome male patient with multiple supplemental supernumerary teeth in three quadrants of his mouth. BACKGROUND: Supernumerary teeth are described as the teeth formed in excess of the number found in a normal dentition. Prevalence of supernumerary teeth varies between 0.1% and 3.8% in the general Caucasian population. Multiple supernumerary teeth are not a common occurrence, although a single or a few supernumerary tooth/teeth in each case have been widely reported in the literature. REPORT: An 11-year-old male presented for a routine preventive dental visit. A routine panoramic radiograph showed the presence of multiple supernumerary teeth which were located in the maxillary right canine incisor region, the maxillary left premolar region, and the mandibular right premolar region. The family's medical history was non-contributory, and an extraoral examination did not reveal any abnormality. SUMMARY: It is rare to find multiple supernumerary teeth in individuals with no other associated diseases or syndromes. This case report presents a case of a non-syndrome male patient with multiple supplemental supernumerary teeth in three quadrants of his mouth.