Eruption Disturbances Research Articles

Eruption Disturbance in Children Receiving Bisphosphonates: Two Case Reports

Background: Bisphosphonates used for the treatment of osteoporosis, hypercalcemia, or heterotopic calcifications can cause serious adverse dental events such as osteonecrosis of the maxillary and mandibular bones. However, the effects in childhood remain scarcely explored. Case Presentations: We encountered two children who had started bisphosphonate therapy before completion of the primary dentition. No systemic disease causing congenital delayed tooth eruption was diagnosed. Although the children’s height and weight increased with age, their tooth eruption was significantly delayed compared with the mean. The primary teeth gradually erupted in the follow-up period; however, some teeth did not completely erupt and needed to be extracted to allow for permanent tooth eruption. Conclusions: We report a case of children with early use of bisphosphonates and eruption disturbance, highlighting the need for further investigation into the relationship between these factors.

Mandibular second molar impaction: introducing a novel and validated 3D classification system

BackgroundMandibular second molar (M2M) impaction is a clinically significant manifestation of eruption disturbance in dental development. The primary aim of this study was to investigate the impact of the three-dimensional (3D) characterization on clinical and therapeutic decisions for M2M impaction. The secondary aim was to introduce a validated 3D classification system incorporating both surgical and orthodontic parameters.MethodsBidimensional (2D) and 3D radiological records of 15 impacted M2M were collected and deidentified. Ten experienced clinicians (5 oral surgeons;5 orthodontists) categorized each case, first based on 2D records and then with 3D scans. The degree of orthodontic and surgical difficulty in treating impacted M2M was evaluated using a novel classification system based on anatomical and radiological features. The primary outcome variable was the assessment of differences in diagnosis and decision-making protocol using 2D or 3D records, where clinical relevance ranged from 0 to 4. The secondary outcome variable was the validation analysis of the proposed 3D classification system to determine the concordance among the clinicians. Descriptive statistics and multivariable inferential analysis based on Akaike information criterion (AIC) were performed (α = 0.05).Results3D examination allowed a better visualization of M2M impaction with higher clinical relevance for diagnosis of M2M root relationship to alveolar nerve and lingual plate, height to alveolar crest, depth, and inclination relative to the first molar and position relative to the third molar (range:2.69–3.43). The proposed 3D classification of M2M impaction changed clinical decisions regarding surgical-orthodontic approach, biomechanics, patient education, and treatment time estimate (range:2.59–3.33). In the validation analysis of the classification, no evidence of inter- or intra-group (surgeon/orthodontist) bias in score attribution occurred: the model with the minimum AIC was the null model (AIC = 718.04).Conclusion3D evaluation of impacted M2Ms could enhance diagnostic accuracy, and a classification system was proposed and validated by a group of experienced surgeons and orthodontists with high concordance.

Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study

This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.

Management and Outcomes of Severe Submergence in Second Premolar

General Background: The early loss of primary molars is a prevalent dental issue that can lead to significant occlusal disturbances, including space reduction and misalignment of permanent teeth. Specific Background: Submergence of the second permanent molar following premature exfoliation of primary molars exacerbates these issues, complicating the eruption pattern and dental arch integrity. Knowledge Gap: Despite existing treatment modalities, there is limited evidence on the effectiveness of specific appliances in managing severe submergence cases in pediatric patients. Aims: This study aims to evaluate the efficacy of the Gerber Space Regainer in restoring lost space and correcting the alignment of submerged second premolars in a pediatric patient. Results: A 10-year-old patient experiencing significant space loss due to premature exfoliation of tooth 85 was treated with a Gerber Space Regainer. Over a 7-week period, the appliance successfully regained 8 mm of space, with notable uprighting of the affected premolar, achieving complete recovery of the dental arch. Novelty: This case report highlights the practical application and success of the Gerber Space Regainer, emphasizing its efficiency in a short time frame, which has not been extensively documented in similar clinical scenarios. Implications: The findings suggest that the Gerber Space Regainer is an effective and reliable option for managing complex orthodontic cases involving submergence and space loss, contributing to the enhancement of treatment protocols in pediatric dentistry. Highlights: Effective space recovery: The Gerber Space Regainer successfully restored 8 mm of lost dental arch space in 7 weeks. Improved alignment: The treatment led to the uprighting of the submerged second premolar, ensuring proper occlusion. Pediatric applicability: The appliance demonstrated high efficiency and compliance in a young patient, showcasing its potential in pediatric cases. Keywords: Premature Loss, Space Regainer, Submergence, Second Premolar, Eruption Disturbance

Abnormal dental phenotypes in GAPO syndrome: A descriptive study with a new ANTXR1 variant & insights on teeth eruption

ObjectiveGAPO syndrome is usually diagnosed clinically owing to its characteristic features of growth retardation, alopecia, pseudoanodontia, and ophthalmic anomalies. Pseudoanodontia describes the failure of eruption of the two sets of teeth in these patients. Thus, the abnormal dental phenotype is the emergence of a set or part of a set of dentitions. PurposeThis study reports the physical, oro-dental, and molecular findings of two new sibs with GAPO syndrome and provides a description of the dental phenotype of one of the patients reported before. Materials & MethodsThe patients were subjected to full medical history taking and three generations-pedigree construction. They were phenotyped according to the elements of morphology: Standard terminology series. After parental consents were acquired, molecular analysis was carried out for the two sibs (Patient 1 & 2). ResultsThese included a new gene variant associated with erupted teeth in GAPO syndrome and new clinical features. A new classification for the terminologies of eruption disturbances was suggested. ConclusionThe study asserts the importance of oro-dental examination and follow-ups as dental updates may occur in these cases.

Ameloblastic fibro-odontoma with a congenitally missing mandibular second molar : a rare case report

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumor predominantly occurring in children. This tumor is often asymptomatic and associated with disturbances in tooth eruption. We present the case of a 7-year-old boy who exhibited delayed eruption of his left mandibular first molar, attributable to AFO with a congenitally missing mandibular second molar. Radiographs revealed a well-defined, ovoid, radiolucent lesion containing sparse calcified materials in the left posterior mandible. To the best of our knowledge, few reports have documented AFO in conjunction with the congenital absence of a permanent tooth. This case is discussed along with a review of relevant literature.

Compound composite odontome-A report of seven case series with brief review of literature.

Odontomes are the most common benign odontogenic tumors of the jaw which are usually slow-growing and non-aggressive. They are generally asymptomatic and diagnosed during routine radiographic investigations and are mostly associated with tooth eruption disturbances. The present case series report covers seven cases of odontomes discussing on clinical, radiographic, and histopathologic features (ground section and decalcification) along with a brief review of the literature.

Orthodontic findings and treatment need in patients with amelogenesis imperfecta: a descriptive analysis

Introduction: Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can commonly be classified into four primary groups. In this retrospective analysis, specific orofacial characteristics are described and associated with each of the AI types based on a patient cohort from Witten/Herdecke University, Germany.MethodsData from 19 patients (ten male and nine female, mean age 12.27 ± 4.06 years) with AI who presented at the Department of Orthodontics between July 2011 and December 2023 were analyzed. Baseline skeletal and dental conditions were assessed, including the presence of hypodontia, displacements, and taurodontism. AI was classified into classes I–IV based on phenotype. Treatment needs were evaluated according to the main findings following the German KIG classification, while the radiological enamel situation was determined using panoramic radiographs.ResultsAn approximately equal distribution between classes II and III was found and a slight inclination toward a dolichofacial configuration (ΔML-NSL: 5.07 ± 9.23°, ΔML-NL: 4.24 ± 8.04°). Regarding orthodontic findings, disturbance in tooth eruption as well as open bite were the most prevalent issues (both 36.8%, n = 7). The most common AI classes were type I and II, which show an almost even distribution about the skeletal classes in sagittal dimension, while dolichofacial configuration was found most frequently in vertical dimension.ConclusionBoth clinical and radiological orthodontic findings in context with AI are subject to extensive distribution. It seems that no specific orofacial findings can be confirmed in association with AI with regard to the common simple classes I–IV. It may be more appropriate to differentiate the many subtypes according to their genetic aspects to identify possible associated orthodontic findings.

Non–syndromic impacted primary molar with eruption disturbance in premolars: A case report of an unusual occurrence

Non–syndromic impacted primary molar with eruption disturbance in premolars: A case report of an unusual occurrence

The Preternatural First Premolar: A Ground Section Tooth Case Report

Ectopic eruption is a developmental disturbance in eruption pattern of permanent dentition most often associated with maxillary first permanent molar (2-6%of general population), mandibular lateral incisors (<1%), maxillary permanent canines (1.5-2%). Ectopic eruption of teeth is a rare phenomenon although cases have been reported in nasal cavity, maxillary sinus, mandible, palate, orbital cavity. Ectopic eruption of mandibular first premolar is a rare condition and there were no discussions in the literature about its eruption in coronoid process. Premature loss of primary second molar and second permanent premolar can lead to disturbed eruption of first premolar. In this case report, we present an ectopic mandibular first premolar at the level of sigmoid notch below the right coronoid process.

Morphometric Comparison and Prognostic Analysis of Permanent Maxillary Central Incisors with Eruption Disturbances-A Cross-Sectional Study.

The aim of this study was to retrospectively compare the morphometrics of permanent maxillary central incisors with and without eruption disturbances, while simultaneously evaluating prognosis based on different factors. Seventy patients with unilateral permanent maxillary central incisor eruption disturbances were included. Within a group of 70 subjects, measurements were taken for both normally erupted central incisors and central incisors with eruption disturbances to determine the length of the roots and the volume of the teeth. Various factors, such as angulation of impaction, and vertical height of impaction, were assessed to investigate their correlation with surgical intervention. Both the root length and tooth volume were significantly smaller in the eruption disturbance incisors than in the normally erupted incisors (p ≤ 0.001). Moreover, there was a statistically significant increase in surgical intervention among cases with no clear physical barrier (primary retention) (p < 0.05) or when adjacent normally erupted central incisors exhibited more than 2/3 of root development (p < 0.05). The results of this study numerically demonstrated the delayed tooth development of the permanent maxillary central incisors with unilateral eruption disturbances compared to appropriately erupted incisors by measuring root length and tooth volume. The absence of obstacles and the degree of root development in adjacent erupted incisors might serve as factors for clinicians to determine the necessity and timing of surgical intervention.

Mini-Implant Insertion Using a Guide Manufactured with Computer-Aided Design and Computer-Aided Manufacturing in an Adolescent Patient Suffering from Tooth Eruption Disturbance.

Due to dental diseases, anatomical restrictions, and mixed dentition, the reduction in the number of teeth and the displacement of tooth germs pose challenges in orthodontic treatment, limiting anchorage options. The presented case demonstrates an advanced treatment solution using digital CAD/CAM-technologies and medical imaging for the creation of a mini-implant template. A 12-year-old male patient experiencing delayed tooth eruption, multiple impacted germs, and maxillary constriction underwent intraoral scanning and CBCT. Utilizing coDiagnostiXTM Version 10.2 software, the acquired data were merged to determine the mini-implant placement and to design the template. The template was then manufactured through stereolithography using surgical-guide material. Mini-implants were inserted using the produced appliance, enabling safe insertion by avoiding vital structures. Surgically exposed displaced teeth were aligned using a Hyrax screw appliance anchored on the mini-implants for rapid palatal expansion (RPE) and subsequently used as fixed orthodontics to align impacted teeth. The screw was activated daily for 10 weeks, resulting in a 7 mm posterior and 5 mm anterior maxillary transversal increase. Skeletal anchorage facilitated simultaneous RPE and tooth alignment, ensuring accuracy, patient safety, and appliance stability. The presented case shows a scenario in which computer-aided navigation for mini-implant positioning can enhance precision and versatility in challenging anatomical cases.

Assessment of Eruption Disturbances in the Mixed Dentition Phase of a Population in Eastern India: A Cross-sectional Study

Context: Eruption disturbances in the primary dentition resulting from environmental and genetic factors can eventually lead to complex anomalies in permanent dentition. If intercepted at an early stage, such anomalies in the permanent dentition can be averted. Aim: In this study, the most common eruption disturbances in the mixed dentition phase have been highlighted in an ethnic group in Eastern India. Materials and Methods: Three thousand children between the ages of 6 and 12 years were randomly chosen with 1330 children in the experimental group and 1670 in the control group. The entire population was divided into two age groups – 6–9 years and 10–12 years. The experimental group had 680 males and 650 females. A total of nine parameters were identified that included premature loss of deciduous teeth, over-retained primary teeth, supernumerary teeth, congenital absence of permanent teeth, ankylosis, eruption cysts, etc., Statistical Analysis Used: The Chi-square test was used for the analysis. Results: Statistically significant differences were observed for each of the parameters considered in this study with respect to the two age groups, namely 6–9 years and 10–12 years, and gender, namely male and female, of the experimental group with P &lt; 0.01%. Conclusion: Accurate understanding of the pattern of eruption disturbances in the mixed dentition period of any ethnic group and/or population is imperative for timely intervention and/or referral by primary care dentists so that malocclusion in the permanent dentition can be intercepted and corrected, thereby improving the quality of life index for that ethnic group/population.

CBCT Assessment of Gubernacular Canals on Permanent Tooth Eruption in Down's Syndrome.

The gubernacular canal (GC) is an important dental structure that enables the alveolar bone ridge cohesion of permanent teeth, although GC absence may indicate a dental eruption that might be associated with certain syndromes such as Down's syndrome. This study aims to correlate the eruptive delay of permanent teeth in individuals with Down's syndrome (Ds) and the gubernacular canal (GC) through cone-beam computed tomography (CBCT). This cross-sectional study was conducted between January and July 2022 with a total of 31 individuals (G1 = 16 nonsyndromic and G2 = 15 Down's syndrome) who went through imaging evaluation using CBCT with the following acquisition parameters: tube voltage of 95 kVp, tube current of 7 mA, exposure time of 5.9 s and voxel sizes and field of view 0.15 mm and 0.30 mm, respectively. The imaging evaluation was to assess whether all teeth analyzed had the presence of GC and/or teeth eruption disturbance, with a descriptive statistical analysis of relative frequencies and quantitative variables as well as the p-value (p < 0.005) by G Test. A total of 618 teeth among 31 individuals were analyzed, 475 (76.8%) GC were detected by CBCT in 23/31 patients and of these, 6 belonged to G2. G2 had a decreased GC detection rate (n = 180-37.9%) and the most common tooth with GC detected was the mandibular 1st molar (21 GC/25 teeth-84%) and the absence of GC was most frequently observed in impacted and delayed/unerupted teeth of Ds individuals. We concluded that GC absence was higher among Ds individuals, explaining the increased rates of unerupted or impacted teeth in Ds individuals.

Radiographic Features of Mandibular Second Molars with Eruption Disturbances: A Retrospective Study.

We aimed to establish the characteristics and potential etiological risk factors of eruption disturbances in mandibular second molars (MM2). We retrospectively enrolled patients with eruption disturbances in MM2. A total of 143 MM2 with eruption disturbances from 112 patients (mean age 17.45 ± 6.35) were included in this study. Panoramic radiographs were employed to determine the risk factor, angulation type, impaction depth, tooth development stage, and associated pathology. The novel classification method of MM2 was based on impaction depth and angulation. Of 143 MM2, 137 and 6 were diagnosed with impaction and retention, respectively. Insufficient space was the most frequent risk factor for eruption disturbances. There were no significant differences between retention and impaction regarding sex, age, or side. The most frequent impaction type was Type I. The most frequent angulation of impacted MM2 was mesioangular. Impacted MM2 with shallower depth were more frequently associated with the presence of first molar undercut. Impaction types did not differ according to age, side, development stage, or distance from the MM1 distal surface to the anterior border of the ramus. Dentigerous cysts were associated with earlier MM2 development stages and greater MM2 depth. In conclusion, MM2 impaction types differed according to the risk factor, angulation type, MM1 undercut, and presence of cysts. Early MM2 development stage and greater MM2 depth were risk factors for MM2 eruption disturbances with cysts.

IDIOPATHIC IMPAIRED TOOTH ERUPTION - AN ORTHODONTIC PERSPECTIVE

Eruption is the continuous process of movement of a tooth from its developmental location inside the jaw to its functional location in the mouth. Impaired tooth eruption, where this process is disturbed, is common in dental practice. It may manifest either as delayed or complete absence of eruption. This article reviews the local and systemic conditions under which IITE has been reported to occur. The terminology related to disturbances in tooth eruption is also reviewed and clarified. A diagnostic algorithm is proposed to aid the clinician in the diagnosis and treatment planning of IITE. The sequential and timely eruption of teeth is critical to the timing of treatment and the selection of an orthodontic treatment modality. This review addresses the need for a more in-depth understanding of the underlying pathophysiology of IITE and gives the clinician a methodology to approach its diagnosis and treatment.

A clinical and statistical investigation of teeth affected by eruption disturbances using cone-beam computed tomography imaging

A clinical and statistical investigation of teeth affected by eruption disturbances using cone-beam computed tomography imaging

A Retrospective Study of Ectopic Eruption in 35 Dogs.

Ectopic eruption results from a disturbance in tooth development and eruption, leading to an erupted or non-erupted tooth being in an unexpected anatomical location. This retrospective case series describes the location, position, form, and clinical signs associated with ectopic eruption in dogs. Thirty-five dogs (46 teeth) were diagnosed with ectopic eruption at three clinical practices during 2017-2020. The cases were described in terms of the location, the development and eruption status, the clinical signs, the consequences, and the treatment performed. The collected data were statistically analyzed to establish possible ramifications. The results showed that the ectopic eruption in the evaluated cases involved permanent teeth, mainly located in the maxilla, and mostly unerupted. Those located in the mandible were significantly more impacted than those located in the maxilla. This study concluded that tooth crowding and malocclusion (39.1%), facial swelling (8.6%), and periodontal disease (8.6%) were associated with the presence of ectopic eruption, and consequently, treatment was required in the majority (65.2%) of cases.

Occurence of Dens Invaginatus in Two of the Four Impacted Mesiodentes - A Rare Case Report

Supernumerary teeth are defined as excess number of teeth as compared to normal dental formula. Mesiodens is a supernumerary tooth in the central region of premaxilla between two central incisors. Multiple Mesiodens are called Mesiodentes. This additional tooth structure may cause disturbance in eruption or position of adjacent teeth. Dens Invaginatus (DI) is a rare tooth malformation showing an infolding of enamel and dentin of affected tooth sometimes extending deep into the pulp cavity and root portion. This paper aims to present a rare association of DI in two of the four impacted Mesiodentes in a 10-year-old girl patient causing eruption disturbance and unaesthetic appearance in anterior maxilla.

Evaluating Spatiotemporal Patterns of Post-Eruption Vegetation Recovery at Unzen Volcano, Japan, from Landsat Time Series

Quantifying vegetation responses after natural disasters helps clarify complex relationships between vegetation and surface processes such as soil erosion. The heterogenous post-disaster landscape offers a naturally stratified environment for this study. Existing research tends to be frequently monitored but small-scale or sporadically monitored but large-scale. The availability of high-quality and free satellite imagery bridges this gap by offering continuous, longer-term observations at the landscape scale. Here we take advantage of a dense Landsat time series to investigate landscape-scale vegetation response rates and factors at Unzen volcano, Japan. We do this by first investigating differences between two popular vegetation indices—The Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR), when applied to recovery studies. We then apply pixel-wise regressions to quantify spatio-temporal vegetation response and regression tree analyses to investigate drivers of recovery. Our findings showed that simple linear-log functions best model recovery rates reflecting primary succession trajectories caused by extreme disturbance and damage. Regression tree analyses showed that despite secondary disturbances, vegetation recovery in both the short and long-term is still dominated by eruption disturbance type and elevation. Finally, compared to NDVI, NBR is a better indicator of structural vegetation regrowth for the early years of revegetation.