Malformed Teeth Research Articles

Dilaceration of permanent teeth after primary tooth trauma

Milk tooth dislocations caused by accidents, especially intrusions and buccal dislocations, can cause considerable malformations of permanent teeth. These malformations occur at the level of the current crown or root formation zone at the time of the accident. Anything that is already fully mineralized is not or hardly affected.

Dual cusped protostylid: Case report and clinical significance

Protostylids are superstructures on maxillary or mandibular molars, which have rarely been reported in literature, and the significance of their presence has also been underestimated. The dental practitioners may easily misdiagnose a tooth, with such conical tubercles as malformed tooth. Interestingly, this is neither a malformation nor an anomaly but rather an important morphological trait of an individual. Once in a while, one may come across such a distinct morphological trait without being able to diagnose. To the authors' best knowledge, only one similar case has been reported previously, and the second such case internationally. Bearing all such facts in mind, the authors attempt to educate the readers towards the existence of such a trait so that it can be identified and studied in larger numbers. Hence, it is the authors' endeavor to report an unusual case of dual cusped maxillary protostylid along with its clinical significance.

Rare presentation of accessory tubercles on permanent maxillary second molar

Tooth malformations may be related to heredity or injury during formation. Such morphological abnormalities may be found in the crown either in the form of anomalous cusps or in an increased number of roots, which in some cases are associated with an anomalous cusp. Cone-like enlargements on the buccal cusp of maxillary molar is one such anomaly. This case presents the anatomical and morphological characteristics of a rare case of three lobulated tubercles on the buccal surface of permanent maxillary right second molar tooth.

Clinical parameter of odontoma with special emphasis on treatment of impacted teeth-a retrospective multicentre study and literature review.

Odontoma-separated into complex (CxOD) and compound (CpOD) subtypes-represents the most frequent odontogenic malformation. Retention of permanent teeth is a common symptom. Therefore, in a series of odontomas, an analysis of the management of retained teeth was conducted. In a retrospective multicenter study of two University Medical Centers and one private praxis in Germany, demographic and clinical data regarding odontomas from 01/2000-03/2015 were obtained. In particular, the influence of operative therapy on the dentition and on the treatment of impacted teeth was analyzed. Forty-five patients with 15 CxOD and 30 CpOD were included. Initial symptoms were delayed eruption of permanent teeth (n=11), pain (n=4), and swellings (n=2); 28 cases were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 1:0.55 (29/16). Thirty-five out of 45 odontomas were in close proximity of at least one tooth (n=16 at molars). A total of 14 teeth were extracted (CxOD: n=5; CpOD: n=9). Extractions had to be conducted more often in older patients (mean age 39.8 vs. 25.6years). Of the non-extracted teeth, 8 teeth were displaced and retained. Of those, 4 teeth were aligned in the dental arch via orthodontic help and 2 teeth erupted spontaneously after operation during the follow-up period. In all cases, no relapse was seen. Odontomas can cause displacement as well as malformation and resorption of the adjacent teeth. Mostly, removal of odontomas is conducted. Extirpation of odontoma can allow for normal tooth eruption, often rendering extractions avoidable. Orthodontic alignment, though sometimes challenging, is a reasonable therapeutic option. These findings underline the value of the panoramic radiograph in preventive dentistry in younger patients.

Expanding the spectrum of human ganglionic eminence region anomalies on fetal magnetic resonance imaging.

Ganglionic eminence (GE) is a transient fetal brain structure that harvests a significant amount of precursors of cortical GABA-ergic interneurons. Prenatal magnetic resonance (MR) imaging features of GE anomalies (i.e., cavitations) have already been reported associated with severe micro-lissencephaly. The purpose of this report was to illustrate the MR imaging features of GE anomalies in conditions other than severe micro-lissencephalies. Among all the fetuses submitted to prenatal MR imaging at our center from 2005 to 2014, we collected eight cases with GE anomalies and only limited associated brain anomalies. The median gestational age at the time of MR imaging was 21weeks ranging from 19 to 29 weeks. Two senior pediatric neuroradiologists categorized the anomalies of the GE region in two groups: group one showing cavitation in the GE region and group two showing enlarged GE region. For each fetal case, associated cranial anomalies were also reported. Five out of the eight cases were included in group one and three in group two. Besides the GE region abnormality, all eight cases had additional intracranial anomalies, such as mild partial callosal agenesis, vermian hypoplasia and rotation, cerebellar hypoplasia, ventriculomegaly, enlarged subarachnoid spaces, molar tooth malformation. Ultrasound generally detected most of the associated intracranial anomalies, prompting the MR investigation; on the contrary in none of the cases, GE anomalies had been detected by ultrasound. Our observation expands the spectrum of human GE anomalies, demonstrating that these may take place also without associated severe micro-lissencephalies.

Multi‐system involvement in a severe variant of fibrodysplasia ossificans progressiva (ACVR1c.772G>A; R258G): A report of two patients

Severe variants of fibrodysplasia ossificans progressiva (FOP) affect <2% of all FOP patients worldwide, but provide an unprecedented opportunity to probe the phenotype-genotype relationships that propel the pathology of this disabling disease. We evaluated two unrelated children who had severe reduction deficits of the hands and feet with absence of nails, progressive heterotopic ossification, hypoplasia of the brain stem, motor and cognitive developmental delays, facial dysmorphology, small malformed teeth, and abnormal hair development. One child had sensorineural hearing loss, microcytic anemia, and a tethered spinal cord and the other had a patent ductus arteriosus and gonadal dysgenesis with sex reversal (karyotype 46, XY female). Both children had an identical mutation in ACVR1 c.772A>G; p.Arg258Gly (R258G), not previously described in FOP. Although many, if not most, FOP mutations directly perturb the structure of the GS regulatory subdomain and presumably the adjacent αC helix, substitution with glycine at R258 may directly alter the position of the helix in the kinase domain, eliminating a key aspect of the autoinhibitory mechanism intrinsic to the wild-type ACVR1 kinase. The high fidelity phenotype-genotype relationship in these unrelated children with the most severe FOP phenotype reported to date suggests that the shared features are due to the dysregulated activity of the mutant kinase during development and postnatally, and provides vital insight into the structural biology and function of ACVR1 as well as the design of small molecule inhibitors.

Communication practices and preferences between orthodontists and general dentists.

To evaluate similarities and differences in orthodontists' and general dentists' perceptions regarding their interdisciplinary communication. Orthodontists (N = 137) and general dentists (N = 144) throughout the United States responded to an invitation to participate in a Web-based and mailed survey, respectively. The results indicated that orthodontists communicated with general dentists using the type of media general dentists preferred to use. As treatment complexity increased, orthodontists shifted from one-way forms of communication (letters) to two-way forms of communication (phone calls; P < .05). Both orthodontists and general dentists reported that orthodontists' communication regarding white spot lesions was inadequate. When treating patients with missing or malformed teeth, orthodontists reported that they sought input from the general dentists at a higher rate than the general dentists reported (P < .005). Orthodontists' and general dentists' perceptions of how often specific types of media were used for interdisciplinary communication were generally similar. They differed, however, with regard to how adequately orthodontists communicated with general dentists and how often orthodontists sought input from general dentists. The methods and extent of communication between orthodontists and general dentists need to be determined on a patient-by-patient basis.

English

Ectodermal Dysplasia (ED) is a rare disorder with defects in two or more of the following structures: the teeth, skin and its appendages including hair, nails, eccrine, and sebaceous glands. Dental manifestations include hypodontia, complete anodontia or malformed teeth. The most common form of the ED is hypohidrotic ED and is usually inherited as an X-linked recessive trait. Female carriers may have a variable degree of clinical manifestations. The condition is thought to occur in approximately 1 in every 100, 000 live births. Dental treatment for these patients varies on an individual basis. Children with ED are often treated for dental problems with conventional adult appearing prosthesis. Here with we are reporting two classical cases of hypohidrotic ED with a review of the literature.

Endodontic and Esthetic Management of Hypolplastic Turner’s Teeth with Severely Dilacerated Roots

Dilaceration refer to an angulation or sharp bend or curve in the root or crown of formed tooth. It is usually occur due to trauma that lead to white or yellow brown discoloration, crown dilaceration, root dilacerations, crown duplication, root duplication, odontoma like malformation etc. This paper elaborated a useful clinical considerations for diagnosis and treatment planning of a severely dilacerated root of malformed tooth having turner’s hypoplasia.

Mutations in EDA and EDAR Genes in a Large Mexican Hispanic Cohort with Hypohidrotic Ectodermal Dysplasia.

Mutations in EDA and EDAR Genes in a Large Mexican Hispanic Cohort with Hypohidrotic Ectodermal Dysplasia.

Conventional Complete Denture in Patients with Ectodermal Dysplasia.

Ectodermal dysplasia is described as heritable conditions that involve anomalies of structures derived from the ectoderm, including hypodontia. In the cases of edentulous young patients, who did not finish their craniofacial growth, treatment with conventional complete denture is a suitable alternative. The aim of this study was to report a case of mandibular edentulism treated with conventional complete denture in a thirteen-year-old patient diagnosed with hidrotic ectodermal dysplasia. Typical features, such as frontal bossing, depressed nasal bridge, protuberant lips, scarce hair, and brittle nails, were visualized during the extraoral examination. The intraoral inspection and radiographic analysis revealed oligodontia, dental malformation, and prolonged retention of deciduous teeth at maxilla and total edentulism at mandible. A conventional complete denture was planned and constructed following the same steps of technique as recommended in adults. Although this option is not a definitive treatment, the patient and his parents were satisfied with his improvement in chewing and speech, as well as with the aesthetic benefits.

Bilateral double dens invaginatus in multituberculated maxillary central incisors with impacted supernumerary teeth: A rare case

Dens Invaginatus (DI) is a rare developmental malformation of teeth, resulting from an infolding of dental papilla. The increased risk of pulpal pathologies associated with DI makes it clinical relevant. Only few cases have been reported where double DI was found associated with supernumerary teeth. Diagnosis of DI with the conventional radiographs is not easy, so advanced imaging modalities are must. This paper highlights a rare case of bilateral double DI in multituberculated maxillary central incisors with impacted supernumerary teeth with its clinical and imaging features.

Dens Invaginatus with a Radicular cyst-A Case report

Ens invaginatus is a developmental malformation of teeth. It is a dental anomaly resulting from invagination of the enamel organ into the dental papilla, during odontogenesis. Affected teeth show a deep infolding of enamel and dentine starting from the foramen caecum or even the tip of the cusps and which may extend deep into the root. Teeth most affected are maxillary lateral incisors. The affected teeth radiographically shows an in folding of enamel and dentine which may extend deep into the pulp cavity and into the root and sometimes even reach the root apex. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. The radiographic examination is the most realistic way to diagnose the invagination. Root canal therapy may present severe problems because of complex anatomy of teeth.

Minimally invasive veneers: current state of the art.

Ceramic veneers are considered a conservative solution for patients requiring improvement of the shape, color, or position of their anterior teeth. Ceramic veneers have been extensively and successfully used to mask intrinsic staining, to give the appearance of straightening, and to correct minor malformations of anterior teeth without the removal of substantial amounts of sound tooth substance. The current literature was reviewed to search for the most important parameters determining the long-term success and correct application of ceramic veneers.

Tooth reshaping as an integral part of orthodontic treatment

Tooth reshaping is becoming an integral part of orthodontic treatment to maximize the aesthetic outcome. The removal of incisor mamelons with Sof-Lex™ discs is a straightforward, easy and minimally invasive way of dramatically improving the appearance of previously unworn incisors. This method can be used during the finishing stages of orthodontic treatment. Clinical Relevance: The dental team often encounters patients with misshapen and malformed teeth. Reshaping teeth is fast becoming an integral part of orthodontic treatment. When used in appropriate cases, tooth reshaping can be an effective, minimally invasive technique to achieve a highly aesthetic result

Craniofacial morphometric analysis of individuals with X-linked hypohidrotic ectodermal dysplasia.

Hypohidrotic ectodermal dysplasia (HED) is the most prevalent type of ectodermal dysplasia (ED). ED is an umbrella term for a group of syndromes characterized by missing or malformed ectodermal structures, including skin, hair, sweat glands, and teeth. The X-linked recessive (XL), autosomal recessive (AR), and autosomal dominant (AD) types of HED are caused by mutations in the genes encoding ectodysplasin (EDA1), EDA receptor (EDAR), or EDAR-associated death domain (EDARADD). Patients with HED have a distinctive facial appearance, yet a quantitative analysis of the HED craniofacial phenotype using advanced three-dimensional (3D) technologies has not been reported. In this study, we characterized craniofacial morphology in subjects with X-linked hypohidrotic ectodermal dysplasia (XLHED) by use of 3D imaging and geometric morphometrics (GM), a technique that uses defined landmarks to quantify size and shape in complex craniofacial morphologies. We found that the XLHED craniofacial phenotype differed significantly from controls. Patients had a smaller and shorter face with a proportionally longer chin and midface, prominent midfacial hypoplasia, a more protrusive chin and mandible, a narrower and more pointed nose, shorter philtrum, a narrower mouth, and a fuller and more rounded lower lip. Our findings refine the phenotype of XLHED and may be useful both for clinical diagnosis of XLHED and to extend understanding of the role of EDA in craniofacial development.

Primary Cilia Integrate Hedgehog and Wnt Signaling during Tooth Development

Many ciliopathies have clinical features that include tooth malformations but how these defects come about is not clear. Here we show that genetic deletion of the motor protein Kif3a in dental mesenchyme results in an arrest in odontogenesis. Incisors are completely missing, and molars are enlarged in Wnt1Cre+Kif3afl/fl embryos. Although amelogenesis and dentinogenesis initiate in the molar tooth bud, both processes terminate prematurely. We demonstrate that loss of Kif3a in dental mesenchyme results in loss of Hedgehog signaling and gain of Wnt signaling in this same tissue. The defective dental mesenchyme then aberrantly signals to the dental epithelia, which prompts an up-regulation in the Hedgehog and Wnt responses in the epithelia and leads to multiple attempts at invagination and an expanded enamel organ. Thus, the primary cilium integrates Hedgehog and Wnt signaling between dental epithelia and mesenchyme, and this cilia-dependent integration is required for proper tooth development.

An Immature Type II Dens Invaginatus in a Mandibular Lateral Incisor with Talon’s Cusp: A Clinical Dilemma to Confront

Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. DI is classified as type I, II, and III by Oehlers depending on the severity of malformation. The maxillary lateral incisor is the most commonly affected tooth. Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI. Occasionally, we can see more than one developmental anomaly occurring in a single tooth. In such cases it becomes important to identify the anomalies and initiate a proper treatment plan for good prognosis. In this paper, an unusual case of DI which clinically presented as a huge talons cusp affecting a mandibular lateral incisor tooth is described. This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions.

Hypohidrotic Ectodermal Dysplasia (ED): A Case Series.

ECTODERMAL DYSPLASIA (ED) IS A RARE DISORDER WITH DEFECTS IN TWO OR MORE OF THE FOLLOWING STRUCTURES: the teeth and the skin and its appendages including hair, nails, eccrine, and sebaceous glands. Dental manifestations include hypodontia, complete anodontia or malformed teeth. The most common form of the ED syndrome is hypohidrotic ED and is usually inherited as an X-linked recessive trait. Female carriers may have a variable degree of clinical manifestations. The condition is thought to occur in approximately 1 in every 100,000 live births. Dental treatment for these patients varies on an individual basis. Children with ED are often treated dentally with conventional adult appearing prosthesis which are focused only on the oral manifestations of the syndrome. We are here reporting two classical cases of hypohidrotic ED with a review of the literature.

Remember the periroot sheet in orthodontic treatment of ectodermal dysplasia patients

Introduction: Root resorption has various etiologies. Recent studies have demonstrated a periroot sheet covering the root. The outermost layer of this sheet is the Malassez' epithelial layer. Tooth malformations are seen in ectodermal dysplasia and it is believed that the ectodermal layer in the periroot sheet differs in cases of ectodermal dysplasia. Case reports: Three cases of unexpected severe root resorption are demonstrated. Two cases were diagnosed with ectodermal dysplasia and the third appeared with thin, curly hair and absence of eyebrows but no ectodermal diagnosis. In the ectodermal cases, there were severe orthodontically provoked resorptions on the teeth that appeared to be permanent but were possibly primary. In the third case, there was heavy resorption on permanent teeth due to orthodontic treatment. Discussion: The orthodontist should be aware that aggressive resorption can occur in cases not diagnosed with ectodermal dysplasia but with signs of ectodermal deviations, and that tooth morphology, hair, and skin are important to observe before proceeding with treatment.