Permanent Mandibular Central Incisors Research Articles

Radiographic assessment of root canal morphology of mandibular central incisors using new classification system: A cross-sectional study.

Lack of basic knowledge about the external and internal anatomies of the root canal system and common variations in teeth may lead to various procedural errors or treatment failure. In this study, the root canal configurations of mandibular incisors and the symmetry of the contralateral incisors of Saudi Arabian subpopulations were analyzed and determined using cone beam computed tomography (CBCT). A retrospective evaluation of 700 patients was conducted, and 1260 fully developed permanent mandibular central incisors were assessed. The number of root canals was determined, and the internal root canal anatomies were categorized based on Ahmed et al.’s criteria. The CBCT images were independently evaluated by 2 trained dentists and an endodontist. The data were assessed using the chi-square and one-way analysis of variance tests. All the mandibular central incisors included in the study were single-rooted. According to Ahmed et al’s classification system, the most common classification (82.6%) was 1ManA1 (Vertucci type I), followed by 1ManA1-2-1 (Vertucci type III; 13%). Second canals were more frequently recorded in the male participants than in the female participants. The root canal configuration between contralateral incisors was largely symmetrical. Most of the mandibular incisors in the examined Saudi Arabian population had a single canal. Nevertheless, a substantial number of patients had a complex root morphology. Hence, CBCT can be utilized as a potential supplementary tool during root canal treatment.

Comparative evaluation of the fracture resistance of reattched fragments using three different retentive methods: An in vitro study

: Traumatic injuries to the anterior teeth are one of the most difficult and perplexing problems faced in the paediatric dentistry. Coronal fracture of the anterior teeth is a common form of dental trauma that mainly affects the maxillary and mandibular incisors. Fragment reattachment has been the preffered technique among clinicians because it has several advantages over the composite restorations such as it is a conservative procedure, maintains original tooth contours, translucence and incisal edge wears at similar rate to adjacent teeth.: To compare and evaluate the fracture resistance of reattached fragments using three different methods.Forty sound permanent mandibular central and lateral incisor were selected and mounted in self-cure acrylic resin. The teeth were sectioned with a diamond disc 3mm short of the incisal edge and they were randomly divided into four groups (n=10). Group I – simple reattachment, group II- internal dentinal groove, group III – vertical groove with fiber reinforced post placement, group IV – overcontouring done before the reattachment procedure. The force required to fracture the specimen were recorded using an onscreen calibration tool of the universal testing machine. The results were statistically analyzed.: The results showed that group I, group II and group IV required lesser force to fracture when compared with group III.: The group restored with fiber reinforced post showed the highest value of fracture strength while the simple reattachment had the lowest value.

Root and Root Canal Morphology of Permanent Mandibular Anterior Teeth in a Sample of Egyptian Population

Objectives The aim of this work was to study the morphology of root and root canals of permanent mandibular anterior teeth in a sample of the Egyptian population. Methods A total of 16 permanent mandibular central incisors (I1), 25 permanent mandibular lateral incisors (I2) and 15 permanent mandibular canines (C) were collected and classified into groups according to shape and number of roots. Molds of pink wax with the samples were submitted for cone beam computed tomography (CBCT). The number and shapes of roots were determined and types of root canals were assessed and classified according to Vertucci's classification. Finally, data was statistically analyzed. Results Regarding the macroscopic appearance of I1, all the samples had one root while I2 had one root with 92%. As for C, 80% of the sample was with one root. CBCT revealed the following configurations, according to Vertucci's classification; Regarding I1, Type I was the most common canal configuration (75%) followed by type II (12.5%) and type III (12.5%) Regarding I2, Type I (60%) was the most common configuration followed by type III (28%). As for C, 66.7% of the sample was represented by type I followed by type III and IV, where each was represented by 13.3%. Conclusions There are morphological variations in the root and root canal anatomies of the mandibular central incisors, lateral incisors, and canines of Egyptian population as compared to other populations.

Compound odontoma causing impaction of primary tooth in a 4-year-old child: case report

Objective: to report a rare case of impaction of a primary mandibular incisor due to the presence of a compound odontoma and describe its clinical management. Case report: a 4-year-old boy presented with a“missing” primary left mandibular lateral incisor. Radiographs showed impaction of the unerupted incisorby adjacent radiopaque structures consistent with a compound odontoma. The patient was recalled periodically for 2 years, at which time surgical excision was performed. The diagnosis of compound odontoma was confirmed histologically, and the permanent mandibular central incisors erupted uneventfully; the patient was referred for orthodontic treatment. Final considerations: this case report describes an unusual case of compound odontoma associated with an unerupted deciduous tooth; odontomas are rare in this age range, occurring predominantly in the second decade of life and in association with impaction of permanent teeth. We also propose a protocol for clinical management of such early-onset cases.

Management of developmental disturbances in a 12 year-old child- A multidisciplinary approach

Manifestation of developmental disturbances of the teeth can be in the form of variations in number, position, size, shape, eruption or structure. Such disturbances may be independent or associated with more generalised disorders. The form and structure of the teeth may be affected by local and general factors. This paper is a report of a 12-year-old girl with missing both permanent mandibular central incisors along with permanent maxillary right central incisor. Past history revealed trauma 5 years back due to fall from height. Radiographic examination revealed congenitally missing permanent mandibular left and right central incisors and dilacerated permanent maxillary right central incisor. A multidisciplinary approach has been presented for management of such cases.

Early Management of Non-Syndromic Hypodontia in a Child: Three-Year Follow-Up

Hypodontia is the congenital absence of few teeth. The early multidisciplinary management of hypodontia assures the reestablishment of the disturbed psychological, aesthetic and oral functions. In this study, the clinical case of a child presenting a non-syndromic hypodontia with three agenesis teeth was described. No evidence of maxillary and mandibular third molars bud formation was noted on the orthopantomograph. To replace the two missing permanent mandibular central incisors, two mini-implants in the mandibular symphyseal region were placed and then restored by individually fixed prostheses. In the maxilla, the permanent canine in a complete transposition, was reshaped with composite resin restoration to replace the missing right permanent lateral incisor. Clinical and radiological reassessments were done 3 years later. The aesthetic and functional evaluations were satisfactory. The marginal bone level was stable with no bone loss. The periodontal health around the mini-implants were confirmed in conjunction with mechanical function.

Evidence of Second Canal between Permanent Mandibular Central and Lateral Incisors in China; a Systematic Review on CBCT Studies.

Introduction Evidence of second canal in permanent mandibular incisors is frequently questioned in dentistry. The difference in evidence between the two teeth is an interesting argument across different countries and ethnicities. So the aim of the systematic review was to investigate the evidence of second canal between permanent mandibular central and lateral incisors in China. Materials and Methods The papers were selected from the electronic databases and hand searching according to inclusion and exclusion criteria. All qualified studies were judged by the reviewers. The selected studies were checked with Joanna Briggs Institute Critical Appraisal tool for prevalence studies. Finally, three studies were selected for the review and meta-analyses. The proportion of the second canal with its confidence interval and forest plot for the meta-analyses were calculated. Results The evidences of second canal in permanent mandibular central and lateral incisors in China were 5.6% and 14.1%. Only one study reported bilateral symmetry of the second canal as 58.7% and 76.1% in the two types of teeth. Out of all canal anatomies, Vertucci's type ΙΙΙ was dominant comprising 4.1% and 11.2% together with other second-canal types comprising 1.4% and 3% in permanent mandibular central and lateral incisors. When the proportions were meta-analyzed, mandibular central incisors had been less numerous OR = 0.35 [0.31, 0.40], 0.33[0.28, 0.39], and 0.42 [0.22, 0.79] in the evidence of second canal, of Type ΙΙΙ, and of other types except Type ΙΙΙ than mandibular lateral incisors in China. Out of all second-canal anatomies, Type ΙΙΙ presented 72.5% and 78.9% along with other second-canal types comprising 24.3% and 21.1% in the two teeth in China. Discussion. There was the evidence of second canal which deviated toward the permanent mandibular lateral incisor also in case of bilateral symmetry, the prevalence of Vertucci's Type ΙΙΙ, and other second-canal types out of all canal anatomies.

Authors' Comments—Long-Term Postoperative Cone-Beam Computed Tomography Analysis of Secondary Bone Grafting in 79 Patients With Unrepaired Alveolar Clefts

Authors' Comments—Long-Term Postoperative Cone-Beam Computed Tomography Analysis of Secondary Bone Grafting in 79 Patients With Unrepaired Alveolar Clefts

Treatment of peri-invagination lesion and vitality preservation in an immature type III dens invaginatus: a case report

BackgroundTo report a case of type III dens invaginatus associated with peri-invagination periodontitis in an immature permanent mandibular central incisor with open apex, in which only the invagination area was treated and vitality was preserved.Case presentationA 9-year-old boy was referred complaining of pain in the mandibular left central incisor. After radiographic examination, an invagination into the pulp chamber of the tooth associated with periapical radiolucency was detected. Endodontic access was performed and the orifice was identified under a dental operating microscope. The invagination area was chemo-mechanically cleaned. After 1 week, the invagination was obturated with mineral trioxide aggregate. During the 2-year follow up period, the tooth was asymptomatic. Radiographic examination revealed significant progression of periapical healing and root development in the main root canal of the tooth.ConclusionNon-surgical root canal treatment of the invagination may preserve pulp vitality, and continuous root development of the tooth.

Does Body Mass Index affect Tooth Eruption Sequence? A Study among 6-7 Years Old Schoolchildren in Chennai, India.

ABSTRACTBackgroundChanges in eruption pattern cause malocclusion and crowding, which lead to poor oral hygiene as well as periodontal disorders. Hence, it is important for the dentist to know the exact tooth eruption sequence to educate the parents. Tooth eruption sequence we follow is based on the Western population.AimAs Indian population differs from the Western population in ethnicity, racially, and dietary habits, etc., an attempt was undertaken to compare eruption sequence of Indian children in accordance with the Western population and also to correlate whether body mass index (BMI) affects tooth eruption.Materials and methodsBody mass index and eruption status of permanent mandibular central incisors and first molars were recorded among 529 schoolchildren in Chennai. Eruption status was examined with the help of mouth mirrors and illumination under natural light. The recorded data were entered into Microsoft Excel 2007 and were analyzed using Chi-square test, z test, and Spearman's correlation test. Level of significance was set as 0.05.ResultsEruption values attained from our study were not consistent with the eruption values reported by Logan and Kronfeld. The present study showed that girls have early tooth eruption than boys. Our findings showed negative correlation with respect to BMI and eruption sequence of 31 (r = −0.133), 41 (r = −0.140), 36 (r = −0.08), and 46 (r = −0.076).ConclusionEruption values reported by Logan and Kronfeld are inappropriate for Indian population. It is also found that obese children had delayed tooth eruption when compared with underweight children who had early tooth eruption.How to cite this articleAnu V, Brindha JR, Carol PT, et al. Does Body Mass Index affect Tooth Eruption Sequence? A Study among 6–7 Years Old Schoolchildren in Chennai, India. Int J Clin Pediatr Dent 2020;13(3):261–263.

A Newly Proposed Regression Equation for Mixed Dentition Analysis Using the Sum of the Width of Permanent Mandibular Central Incisors and Permanent Mandibular First Molars as a Predictor of Width of Unerupted Canine and Premolars

Objective: To determine linear regression equation to predict the mesiodistal widths of the permanent canines and premolars based on the sum of the widths of the two permanent mandibular first molars and two mandibular central incisors. Material and Methods: The sample consisted of 800 (400 males and 400 females) permanent dentition casts of Chhattisgarh population. Mesiodistal crown widths of teeth were measured with digital caliper. The correlation and linear regression equations between the calculated four teeth (two permanent mandibular first molars and two central incisors) and the canine-premolars segments of both the arches were developed. Results: No significant differences were found in right and left side of the arch. Sexual dimorphism was significant in teeth sizes with higher mesiodistal dimension in males. A good correlation values varying from 0.51 to 0.67 was found. New standardized regression equations were formulated for the prediction of the mesiodistal widths of unerupted canines and premolars for Chhattisgarh population. Conclusion: Calculating mesiodistal widths of unerupted canine and premolars with help of two permanent mandibular molars and two mandibular central incisors, which erupt early in the oral cavity, can be an alternative and best predictor for the mixed dentition analysis.

The Presence of Distolingual Root in Mandibular First Molars Is Correlated with Complicated Root Canal Morphology of Mandibular Central Incisors: A Cone-beam Computed Tomographic Study in a Taiwanese Population

IntroductionThe aim of this study was to assess the prevalence of complicated root canals in permanent mandibular central incisors (PMCIs) and its correlation with the presence of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic imaging in a Taiwanese population. MethodsA total of 400 patients (800 pairs of PMCIs and PMFMs) were qualified for further analysis. The prevalence of DLRs in PMFMs along with root canal configurations of PMCIs were assessed at subject and tooth levels. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMCIs with the existence of DLRs in PMFMs. ResultsThe prevalence of PMFMs with DLRs and complicated root canal configurations in PMCIs was 23.0% and 15.6%, respectively. A significant difference in age (<50 years vs ≥50 years) was found for complicated root canal configurations in PMCIs. The most prevalent root canal system in PMCIs was Vertucci type I (84.4%) followed by type III (13.5%). A positive correlation between the presence of DLRs in PMFMs and complicated root canal configurations in PMCIs was noted. After adjusting for categoric variables including sex, age, and side, the odds ratios for the occurrence of complicated root canal configurations of PMCIs in the unilateral DLR group and the bilateral DLR group compared with the non-DLR group were 2.13 and 2.53, respectively. ConclusionsThe concurrent appearance of DLRs in PMFMs and complicated root canal morphology in PMCIs is prominent in Taiwanese individuals.

Frontonasal dysplasia: oral features, restorative and orthodontic dental treatment in a child

Frontonasal dysplasia is a complex rare malformation, characterised by abnormalities involving the central portion of the face, especially the eyes, nose and forehead. It can manifest independently or associated with other abnormalities as part of some syndromes. The purpose of this case report was to describe a 5-year-old patient, diagnosed with frontonasal dysplasia. Among the abnormalities characterised with this disorder were ocular hypertelorism, broad nose tip with median notch, median facial cleft, bifid anterior skull, low set hairline, Poland's syndactyly and ankyloglossia. Consisted of behavioural management, oral hygiene instruction, prophylaxis, topical fluoride application, extraction of primary teeth, composite resin restorations and sealants in pits and fissures. Preformed metal crowns were also applied to the right and left primary maxillary second molars. Currently, the patient is 11years-old in the permanent dentition and therefore was referred for corrective orthodontic and periodontal treatments due to the persistence of gingival retraction of the permanent mandibular right central incisor. The treatment in this case was directed to the promotion of oral health and orthodontic corrections, which are of fundamental importance due to medical, physical and social limitations of children affected by this syndrome, hindering healing and rehabilitative treatment. Paediatric dentists should be included in multidisciplinary teams providing care to patients with special needs, improving their quality of life.

Root canal morphology and assessment of incidence, type, and position of isthmus in permanent mandibular central incisor in North Indian population: An in vitro study

Background and Objectives: Mandibular incisor's anatomy presents a challenge when making endodontic access because of its small size and high prevalence of two canals and isthmus within them. The main objective of this study is to evaluate the root canal anatomy and its aberrant morphology in mandibular central incisors. Knowing the variations in canal anatomy such as two canals, presence of isthmus, type, its prevalence, and position in the mandibular central incisors, which help improve the procedure of successful root canal treatment. Materials and Methods: One hundred and twenty extracted human mandibular central incisor teeth were collected. Two different studies have been performed. Sixty teeth were studied through tooth clearing and dye penetration technique. Teeth were decalcified with 5% nitric acid, dehydrated with increasing concentrations of alcohol and rendered clear by immersion in methyl salicylate. Hematoxylin dye was inserted in access cavity and canals. The samples were observed under dental operating microscope. These samples were evaluated for root canal morphology to assess its root canal configuration. Sixty teeth were studied through sectioning of apical 3 mm (1, 2, and 3 mm from the apex) simulating a surgical resection method was followed. The sectioned samples were observed under stereomicroscope for evaluating isthmus and its type. Results and Conclusion: Sectioning study showed that canal shapes varied from round to oval, long oval, and ribbon shaped, while the prevalence of isthmus was more at 3 mm section. Tooth clearing study showed that 46.6% teeth had single canal, 49.8% teeth had two canals, and only 5% teeth had two separate apical foramina.

Early treatment of nonsyndromic oligodontia: a clinical case report

This report aims to describe the clinical case of a 10-year-old male patient (R.C.B.C.), presenting nonsyndromic oligodontia with maternal family trait and absence of 22 permanent teeth. Clinically, the patient had prolonged retention of some primary teeth and presence of permanent maxillary left central incisor, permanent mandibular right central incisor and four first permanent molars. Radiographically, only permanent maxillary second molars and mandibular third molars were developing, whereas all other germs of permanent teeth were missing. Treatment consisted of maxillary expansion followed by moving permanent maxillary left central incisor bucco-mesially, and rehabilitation of spaces with removable denture, where the main goal was to restore function and esthetic harmony. The case has been monitored for the past six years. Nonsyndromic oligodontia is a rare condition that poses significant functional and psychosocial difficulties. Treatment usually requires a multidisciplinary approach among which pediatric dentistry and orthodontics play a major role. In view of its complexity, treatment should be initiated as early as possible to minimize future functional and aesthetic issues. Dental implants are considered as definitive treatment of cases of oligodontia, however, until the patient reached the ideal age, other treatments to ensure aesthetics and function must be performed.

Congenitally Missing Permanent Mandibular Central Incisors and Maxillary Second Molars in Conjunction with a Supernumerary Mandibular Central Incisor

ABSTRACT Congenitally missing teeth are one of the most common dental anomalies which may be termed as dental agenesis. Polygenesis, the formation of one or more supernumerary teeth, occurs much less frequently than agenesis. Hypodontia and hyperdontia are regarded as the opposite dental developmental anomalies. However, their simultaneous presence in the same individual is a rare condition. A case of concomitant hypo-hyperdontia (CHH) is presented here, wherein a 20-year-old female has missing mandibular central incisors, maxillary second molars, and all the third molars. In addition, she has a malformed supernumerary tooth in the mandibular left anterior region. Documentation of such rare case reports is necessary as it helps in minimizing the clinicians' challenge in diagnosing such cases and thus helpful in providing a multidisciplinary approach in treating such patients. How to cite this article Gupta N, Kadu A, Marya CM, Nagpal R, Oberoi S, Dahiya V. Congenitally Missing Permanent Mandibular Central Incisors and Maxillary Second Molars in Conjunction with a Supernumerary Mandibular Central Incisor. J Oral Health Comm Dent 2017;11(2):44-47.

Age estimation and eruption of permanent teeth between two genders-A cross sectional study

Identification is necessary in living persons, recently dead, decomposed bodies, mutilated bodies, skeletonised bodies etc. Age estimation constitutes one of the important tools for identification of a person, both in civil and criminal cases. Teeth are the most reliable material in identification and age estimation in the dead as they do not undergo mutilation by fire or decomposition A tooth is considered to be erupted when the crown or any part of the tooth becomes clinically visible in the oral cavity. The present study was conducted to collect the cross-sectional data for the time and sequence of eruption of permanent teeth among the school going children of north Indian population. The age group was limited to 6 to 14 years, which includes the age range at which all permanent teeth have been found to be erupted, except the third molars. Schools registered with Directorate of school education were considered for the study. A total of 1804 subjects were examined. The mean age of eruption of mandibular first molar has been found to be earlier than the permanent mandibular central incisor as well as earlier in females compared to males. Also the mean age of eruption of any tooth has been found to be earlier in mandible as compared to maxilla in both males and female. Permanent teeth erupted earlier in females than in males and also earlier in mandible compared to maxilla.

Mandibular talon cusp - a case report

Talon cusp is a relatively rare developmental dental anomaly, characterized by cusp-like projections from the cingulum area, or cemento-enamel junction of maxillary or mandibular anterior teeth, in both the primary and permanent dentition. In most of the cases it involves maxillary lateral incisors. The anomaly has been reported to be rare especially when it occurs on mandibular teeth. This article reports a case of talon cusp on permanent mandibular central incisor, which makes it a rare entity.

Bilateral taurodontism in primary and permanent molars associated with hypodontia

The article is to present a case of bilateral taurodontism in primary and permanent molars associated with hypodontia and to discuss the endodontic aspects. Taurodontism in permanent molars are most commonly affected and it has a very low incidence, and very fewer cases are reported in the literature in the deciduous dentition. A 12-year-old boy presented with irregularly placed tooth in upper right back region of the jaw. Orthopantomogramrevealed taurodontism in seven teeth including both primary and permanent teeth, associated with congenitally missing three premolars and permanent mandibular central incisors. Taurodontism is more frequent in nonsyndromic familial tooth agenesis. Individuals in families with second premolar and molar oligodontia are more likely to have taurodontism. Since there is a wide variation in size and shape of pulp chamber with varying degree of obliteration and canal configuration, root canal therapy becomes a challenge so it is essential to recognize and render preventive care for these teeth.

Concurrent occurrence of multiple developmental anomalies: A rare case report and review of literature

Talon cusp and fusion are uncommon odontogenic anomalies comprising of both primary and permanent dentition, which occur on the palatal surface of permanent maxillary incisors, while fused teeth are more common in the primary anterior dentition. This article reports an unusual case of talon cusp presenting on the lingual surface of fused permanent right mandibular central and lateral incisor in the permanent dentition in association with impacted left mandibular third molar. Recognition of this condition and early diagnosis are important to provide prophylactic measures, thereby preventing complications.