Deciduous Central Incisors Research Articles

EDA Variants Are Responsible for Approximately 90% of Deciduous Tooth Agenesis.

Deciduous tooth agenesis is a severe craniofacial developmental defect because it affects masticatory function from infancy and may result in delayed growth and development. Here, we aimed to identify the crucial pathogenic genes and clinical features of patients with deciduous tooth agenesis. We recruited 84 patients with severe deciduous tooth agenesis. Whole-exome and Sanger sequencing were used to identify the causative variants. Phenotype-genotype correlation analysis was conducted. We identified 54 different variants in 8 genes in 84 patients, including EDA (73, 86.9%), PAX9 (2, 2.4%), LRP6 (2, 2.4%), MSX1 (2, 2.4%), BMP4 (1, 1.2%), WNT10A (1, 1.2%), PITX2 (1, 1.2%), and EDARADD (1, 1.2%). Variants in ectodysplasin A (EDA) accounted for 86.9% of patients with deciduous tooth agenesis. Patients with the EDA variants had an average of 15.4 missing deciduous teeth. Mandibular deciduous central incisors had the highest missing rate (100%), followed by maxillary deciduous lateral incisors (98.8%) and mandibular deciduous lateral incisors (97.7%). Our results indicated that EDA gene variants are major pathogenic factors for deciduous tooth agenesis, and EDA is specifically required for deciduous tooth development. The results provide guidance for clinical diagnosis and genetic counseling of deciduous tooth agenesis.

Pyogenic granuloma of maxillary median gingiva in a pediatric patient: A case report and literature review

Pyogenic granuloma (PG) is a painless pedunculated granulomatous lesion that develops on the skin and mucous membranes. PG in children is relatively rare. We herein report a case of PG of the maxillary median gingiva in a pediatric patient. The patient was a 6-year-old Japanese boy who presented with a painless mass with bleeding after exfoliation of the left upper deciduous central incisor. The lesion had undergone continuous, rapid growth for approximately 10 days. Intraoral findings revealed a painless, elastic, soft, and non-pedunculated mass, measuring 15 × 10 mm, in the left upper deciduous central incisor area. To differentiate it from malignancy, an excisional biopsy was performed on the patient under general anesthesia. Histological findings confirmed that the patient suffered from PG. At the time of writing this paper, the patient had been clinically followed up for the 18th month after the surgery, showing no signs of tumor recurrence.

Comparative evaluation and influence of different post on stress distribution in deciduous central incisor: A finite element analysis C

Comparative evaluation and influence of different post on stress distribution in deciduous central incisor: A finite element analysis C

Growth and Development Factors of Infants and Maternal Conditions During Pregnancy for the Eruption of the First Deciduous Teeth (Literature Review)

Tooth eruption is a condition in which the cusp or incisal of the tooth emerges through the gingiva, but not exceeding 3mm above this level after the corona is formed. The first human tooth that erupts is the mandibular primary central incisor, which is the reference for the eruption of others, including the primary and permanent teeth, that support the growth of the jaw, face, mastication, swallowing, speech, and aesthetics. Furthermore, tooth eruption is influenced by the growth and development of the fetus during pregnancy. Maternal conditions during pregnancy such as age, level of education, physical condition, and nutritional intake affect fetal nutrition which indicates the level of growth and development in the form of head circumference, birth weight, and height that affect the eruption time of the mandibular deciduous central incisor. During pregnancy, the maternal preparation to be considered is the age which might range from 20-35 years, adequate nutritional intake of carbohydrates, folic acid, protein, vitamin C, vitamin D, and minerals, prevention of physical fatigue, intelligence in choosing nutrition, and abstaining from alcohol and caffeine consumption. This study aims to provide information/education on the preparation of pregnant women for the eruption of the mandibular primary central incisor which is part of the infant's growth and development.

Displacement and Arrest of Root Formation in a Permanent Maxillary Central Incisor Subsequent to Trauma to the Primary Predecessor: A Case Report

The present report aimed to explore the case of an 8-year-old patient with chief complaint of the lack of eruption of the maxillary right permanent central incisor, referring to the Department of Pediatric Dentistry, Faculty of Dentistry, Hamadan University of Medical Sciences. The corresponding tooth on the contralateral side had fully erupted. The patient’s history revealed that the predecessor deciduous tooth had sustained a trauma, resulting in the partial intrusion of the tooth into the alveolar bone, that is, the relative intrusion of the deciduous central incisor. CBCT examinations were ordered for further evaluation, which showed the upward displacement of the permanent tooth bud in the alveolar bone as a result of the trauma, adhering to the floor of the nasal cavity. Therefore, root formation was halted, making the tooth embedded.

Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study.

Aim and objectiveThe study was conducted to assess and compare the remineralization ability of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), bioactive glass-ceramic, and nanohydroxyapatite crystals using a confocal microscope.Materials and methodsEighty premolars and 80 deciduous central incisors were included in this study. Two windows of approximately 3 × 3 mm were created on the labial surface of the premolars and 2 × 2 mm on deciduous maxillary incisors. Artificial caries like lesions was created by demineralizing the sample windows. The teeth sections were then randomly assigned into four groups (n = 20). Specimens of the first group were once painted with fluoride varnish, while those in CPP-ACPF, bioactive glass-ceramic, and nanohydroxyapatite were brushed twice daily for 2 minutes each for 40 days, respectively. 150–200 μm longitudinal sections were obtained and were photographed under a confocal laser scanning microscope. They were quantified using a computerized imaging system for demineralization and later for remineralization. The recorded values were tabulated and analyzed using Fisher's test, analysis of variance (ANOVA), and post hoc Bonferroni's test.ResultsAll the materials used in the study showed remineralization potential at the end of 40 days in both permanent and deciduous teeth. The highest remineralization potential was observed in the fluoride varnish group followed by bioactive glass, CPP-ACFP, and nanohydroxyapatite in both permanent and deciduous teeth. In permanent teeth, the difference in the remineralization potential of fluoride varnish and bioactive glass was not statistically significant.ConclusionThe present study showed that self-applied bioactive glass has similar remineralization potential to fluoride varnish in permanent teeth. Therefore, bioactive glass can be used for the management of incipient caries lesions daily.How to cite this articleGoel T, Singhal A, Singh I, et al. Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(S-1):S34–S39.

Unusual Presentation of a Pyogenic Granuloma in a 6-Year-Old Child

A 6-year-old girl was referred for assessment of an oral soft tissue swelling in the anterior maxilla. An asymptomatic, large, erythematous soft tissue mass developed on the alveolar ridge following the loss of the deciduous upper central incisor. Following excision of the lesion, a diagnosis of pyogenic granuloma was confirmed. This case demonstrates the unusual presentation of a pyogenic granuloma in a younger child. These lesions can arise as a reactive response to various stimulating factors and can grow rapidly. Management often involves excision but recurrence risk can be high. CPD/Clinical Relevance: Dentists should not only be aware of the common oral soft tissue changes but should also familiarize themselves with lesions that can occur atypically in children.

Prevalence and influencing factors of deciduous caries in preschool children in Chongqing city

This study aimed to determine the prevalence and related factors of deciduous caries in 3-5-year-old preschool children in Chongqing city. Results will be used to provide a basis for the establishment and adjustment of prevention and intervention of caries in preschool children. We referred to the Fourth National Oral Health Epidemiological Survey. Data included caries prevalence in preschool children, and the questionnaires were distributed to children' parents in Chongqing city. Results were inputted by Epidata 3.1 and statistically analyzed using SPSS 21.0. A total of 1 350 preschool children were included in the study. We found that maxillary deciduous central incisor and mandibular deciduous molars were susceptible to decay. The prevalence of primary teeth caries in preschool children in Chongqing city was 51.4% (694/1 350). The mean decayed-missing-filled-teeth (dmft) index was 2.34. The caries prevalence and mean dmft between age groups were statistically significant (P<0.01) and increased with age (P<0.05). However, except the 5-year-old group (P<0.05), no significant difference in caries prevalence rate and mean dmft was found between male and female children (P>0.05). Approximately 61.7% of caries cases were concentrated in a small number (36.1%) of individuals. Multivariate Logistic regression analysis showed that age, highest educational level of parents, intake frequency of sweetened beverages and carbonated drinks, toothache or similar discomfort experience over the past year, dentist visits, and parents' assessment of teeth and oral health status of children were the factors influencing the prevalence of deciduous caries (P<0.05). More than half of the preschool children had dental caries. Majority of caries were concentrated in a small number of individuals. The age of children, highest educational level of parents, intake frequency of sweetened beverages and carbonated drinks, toothache or discomfort experience over the past year, dentist visits, and parents' assessment of teeth and oral health status of children were associated with the prevalence of deciduous caries.

Diet and lifestyle habits associated with caries in deciduous teeth among 3- to 5-year-old preschool children in Jiangxi province, China

BackgroundThe purpose of this study was to investigate the status of caries in deciduous teeth and the effect of diet and lifestyle habits on dental caries among 3- to 5-year-old preschool children in Jiangxi Province, China.MethodsIn total, 2880 cases involving preschool children were selected by stratified cluster sampling. The dental examination methods and criteria followed the WHO guidelines. SPSS 19.0 was used for the statistical analysis. Chi square tests were used to compare the caries prevalence among children with different social characteristics. Non-parametric tests were used to compare the decayed, missing and filled teeth (dmft) index values. Univariate and multivariate regression analyses were used to study the effect of diet and lifestyle habits on dental caries.ResultsThe caries prevalence among the 2880 cases of 3- to 5-year-old preschool children in Jiangxi Province, China was 49.13%. There was no gender difference in this rate (P > 0.05). The caries prevalence increased with age (P < 0.05). The prevalence of caries in the rural areas was higher than that in the urban areas (P < 0.05). The deciduous central incisors and deciduous molars had a higher caries prevalence than the other deciduous teeth. According to the multivariate logistic regression analysis, the caries risk increased with living in a rural area, exclusive breastfeeding, greater frequency of daily snacking, high frequency of snacking before sleep and beginning to brush teeth at a late age; the caries risk decreased when parents helped their children brush their teeth.ConclusionThe caries prevalence among 3- to 5-year-old preschool children in Jiangxi was lower than the level throughout the country and lower than the rate in other developing countries. The children’s diet and lifestyle habits were closely related to dental caries. Parents and children should be more aware of oral health, and parents should help their children develop healthy lifestyle behaviours.

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Objective: To analyze the chronology of first deciduous tooth eruption in children with microcephaly associated with presumed or confirmed Zika virus. Methods: A longitudinal study was developed with 74 children of both sexes. Data on prematurity, gestational age (in weeks), anthropometric characteristics at birth [length (cm), weight (g) and cephalic perimeter (cm)] and dental eruption (chronological age and corrected age for prematurity in months) were collected and presented through descriptive statistics. Results: The majority of children were female (54.1%) and 14.9% were born premature. The mean gestational age was 38.2 (± 1.9) weeks, while length, weight and cephalic perimeter at birth were 45.6 (± 3.1) cm, 2750 (± 526.6) and 30 (± 2.3) cm, respectively. The eruption of the first tooth occurred on average at 12.3 (± 3.0) months of chronological age and at 11.1 (± 2.3) months of corrected age. The first erupted teeth were the lower deciduous central incisors (82.4%). The mean age for dental eruption in males was 12.5 months (± 3.0) and in females 12.0 months (± 3.1) among full-term children. For premature infants, the mean corrected age of dental eruption was 11.5 months (± 3.4) for boys and 11 months (± 1.7) for girls. Conclusion: In this group of children with microcephaly, the first tooth to erupt was the lower central incisor around the first year of life. Girls had lower average eruption time when compared to boys in both chronological age and age corrected for prematurity.

New regression formula to estimate the prenatal crown formation time of human deciduous central incisors derived from a Roman Imperial sample (Velia, Salerno, Italy, I-II cent. CE).

The characterization and quantification of human dental enamel microstructure, in both permanent and deciduous teeth, allows us to document crucial growth parameters and to identify stressful events, thus contributing to the reconstruction of the past life history of an individual. Most studies to date have focused on the more accessible post-natal portion of the deciduous dental enamel, even though the analysis of prenatal enamel is pivotal in understanding fetal growth, and reveals information about the mother’s health status during pregnancy. This contribution reports new data describing the prenatal enamel development of 18 central deciduous incisors from the Imperial Roman necropolis of Velia (I-II century CE, Salerno, Italy). Histomorphometrical analysis was performed to collect data on prenatal crown formation times, daily secretion rates and enamel extension rates. Results for the Velia sample allowed us to derive a new regression formula, using a robust statistical approach, that describes the average rates of deciduous enamel formation. This can now be used as a reference for pre-industrial populations. The same regression formula, even when daily incremental markings are difficult to visualize, may provide a clue to predicting the proportion of infants born full term and pre-term in an archaeological series.

Variations in bone density across the body of the immature human mandible.

During growth the mandible accommodates increases in biomechanical loading resulting from changes in the function of structures of the oral cavity. Biomechanical loads are thought to play an intricate and vital role in the modelling and remodelling of bone, with site-specific effects on bone mineral density. It is anticipated that the effects of this loading on bone mineral density are intensified during the functional transition from prenatal to postnatal stages. The aim of this study was thus to evaluate changes in bone mineraldensity across the body of the immature human mandible during the early stages of dental development. The study sample included 45 human mandibles, subdivided into three age groups: prenatal (30 gestational weeks to birth; n = 15); early postnatal (birth to 12 months; n = 18); and late postnatal (1-5 years; n = 12). Mandibles were scanned using X-ray micro-computed tomography. Eight landmarks were selected along the buccal/labial and lingual surfaces of each dental crypt for evaluation of the bone mineral density. Bone mineral density values were calculated using a reference standard and analysed using multivariate statistics. The bone mineral density of the lingual surface was found to be significantly higher (P ≤ 0.000) than that of the buccal/labial surface. Furthermore, bone mineral density in the alveolar region of the buccal/labial surface of the deciduous central incisor (P ≤ 0.001), the deciduous first molar (P ≤ 0.013) and lingual alveolar area of the deciduous second molar (P ≤ 0.032) were significantly greater in the early postnatal period than in the prenatal period. While changes in bone mineral density across the lingual surface were consistent with the progression of development and the biomechanical demand of the tongue as previously demonstrated, changes observed across the buccal/labial surface of the mandible appeared to accompany the advancing dental development. Thus, changes in bone mineral density across the mandible appear to be reflective of the stage of dental development and the level of biomechanical loading.

Fragment reattachment of a complicated crown-root fracture in primary maxillary central Incisor and 1 year follow-up

Coronal fracture of anterior teeth is a common form of dental trauma that affects children and adolescents. It is a tragic experience, which requires immediate attention and quick functional and esthetic repair. The major challenge for the clinician for managing such type of dental injuries is to re-establish the natural esthetics of the traumatized anterior tooth. Traditionally, such injuries have been restored with composite resins. They have the primary disadvantage of color mismatch and variable wear. Therefore, if a broken fragment is available, the restoration of the tooth using its own fragment should be the first treatment of choice. This clinical report describes reattachment of tooth fragment of complicated crown-root fracture of a deciduous maxillary central incisor in a 4-year-old child following trauma.

A case of replantation of deciduous upper central incisors under different extra-alveolar conditions

PurposeThe extra-alveolar condition of an avulsed tooth is important for its successful replantation. Here we report a case of deciduous incisors replantation under different extra-alveolar conditions. Case reportTraumatically avulsed upper deciduous central incisors of a 3-year-old girl were replanted. Two hours before replantation, the left incisor was in a moist condition, while the right one was dry. After 3 years, we found that the deciduous incisors were correctly replaced by their successors. ConclusionThe difference in extra-alveolar conditions between both avulsed deciduous central incisors did not produce significant differences between them after replantation.

Measurement of Deciduous Teeth Size in Selected Sample of Iranian Population

Background: Tooth size is an important factor that affects alignment of the teeth in the dental arch and occlusion development during dentition transition. Objectives: This study was carried out to measure mesiodistal dimensions of primary teeth to provide standard for the tooth size. Knowledge of such a standard of tooth size is significant for a better analysis of the space and more appropriate planning of orthodontic treatments. Patients and Methods: The current study was conducted on 32 children, aged 5.5 - 6.5 years, in late primary dentition. The dental casts were prepared and the tooth size was measured by a digital caliper. The obtained data were analyzed by ANOVA and t-test. Results: The mesiodistal width of primary central incisor in the upper left quadrant was larger than those of the rest of quadrants. Also, the mesiodistal widths of primary lateral incisors in the upper left quadrant, primary canines in the upper left quadrant, primary fist molars in the lower right quadrant and primary second molars in the lower left quadrant were larger than those of the other quadrants. Moreover, it was concluded that the mesiodistal diameter of permanent central incisors could be obtained according to the primary central incisors using the formula: 1.12 × (Deciduous central incisor width) + 1.27 = (Permanent central incisor width). Conclusions: The findings of this study can be used as a base and standard for the measurement of primary dentition in Iranian children. Also, measurement of mesiodistal width of deciduous central incisors can be used to predict the mesiodistal width of permanent central incisors.

A Study of the Potential of Deciduous Incisor Wear as an Indicator of Weaning Using a Human Skeletal Population

AbstractThe aim of this work is to investigate the potential of wear on the earliest erupting teeth, the deciduous central incisors, for studying weaning in human skeletal populations. The study group is from mediaeval Wharram Percy, where existing δ15N data indicate cessation of breastfeeding occurred by about 24 months post‐partum. The hypothesis tested is that there should be an increase in dental wear as breast milk is replaced with solid foods during weaning. Incisor wear is monitored using crown heights, measured from photographs using image analysis. Results provide little evidence for alteration in incisor wear rates with the attenuation of breastfeeding, perhaps because abrasive foods were used as supplements well before breastfeeding declined. Copyright © 2015 John Wiley &amp; Sons, Ltd.

Fusion of deciduous central incisors

Fusion is a common dental anomaly affecting both primary as well permanent dentitions. Fusion is the union between two normally separated tooth germs. The problems associated with fused teeth are esthetics, arch symmetry, spacing, and malocclusion. These problems require cosmetic and orthodontic consideration.

An unusual incidental radiographic finding - a stapler pin: A case report

Accidental discovery of a foreign object embedded in a tooth is not common. Children often have a habit of inserting objects into their mouth. Some of these objects can be accidentally ingested or even aspirated which can be a very frightening and a stressful experience. Herein, we report a case of a 7-year-old boy who presented with a stapler pin lodged in the root canal space of maxillary left deciduous central incisor.

Maxillary Growth After the Use of Protraction Head Gear in Conjunction With Presurgical Orthopedics and Gingivoperiosteoplasty for Complete Bilateral Cleft Lip and Alveolus Patients

Maxillary development is often inadequate in bilateral cleft patients. The use of presurgical orthopedics (PSO) and gingivoperiosteoplasty (GPP) may promote bone formation at the alveolar cleft, but can also have detrimental effects on maxillary development. Our objective was to investigate the effect of PSO and GPP on maxillary development in bilateral cleft lip and alveolus (BCLA) patients. We had 3 complete BCLA patients who had received PSO. All patients underwent cheiloplasty and GPP simultaneously. At 4 years, maxillary protraction head gear was used as part of the protocol. They were evaluated by cephalometric analysis at 4 and 8 years of age, and by CT imaging at 5 years of age. At 4 years of age, patients with all BCLA had anterior crossbite of deciduous central incisors. As a result of maxillary protraction, jaw development at 8 years was good. Among all patients, only one showed bone formation at the alveolar cleft sufficient to avoid alveolar bone grafting (ABG). All patients presented anterior crossbite in the premaxillary region, but had good maxillary growth at 8 years old as a result of maxillary protraction. The combination of PSO and GPP can potentially eliminate the need for ABG and does not significantly retard maxillary development. PSO with GPP and protraction head gear may be an option, but long-term growth is not known.

Tessier 30 symphyseal mandibular cleft: Early simultaneous soft and hard tissue correction – A case report

A symphyseal mandibular facial cleft (Tessier 30) is a rare congenital abnormality. Nonunion of bone in the symphysis of the mandible, median cleft of the lower lip and tongue adherence in the midline to the floor of the mouth are the principle features of the anomaly. A satisfactory result can be achieved with early surgical correction of both hard and soft tissue defects in the age of 6 months. More than 3 years follow-up shows total bony fusion of the symphysis and normal lower lip function. There were only left deciduous central incisor and the ipsilateral tooth bud of the permanent central incisor missing.