Tooth Transposition Research Articles

Associação da má oclusão de Classe II Divisão 2 com anomalias do desenvolvimento dentário

AimThe aim of this study is to investigate the existence of an association between Class II Division 2 malocclusion and some dental development anomalies. Materials and methodsUsing the initial orthodontic records, 137 Class II Division 2 malocclusions were examined. For each patient, the presence of the following dental development anomalies was determined: tooth impaction, tooth agenesis, upper lateral incisor microdontia, tooth transpositions and supernumerary teeth. Results57,7% of patients were diagnosed with at least one of the dental anomalies studied. In the total sample the prevalence rates were determined as follows: 20,4% of palatal maxillary canine impaction, 27,6% of third molar agenesis, 9,5% of upper lateral incisor agenesis, 37,0% of total tooth agenesis and 13,9% of upper lateral incisor microdontia. No tooth transpositions or supernumerary teeth were found in any patient. ConclusionsBy comparing our results with prevalence studies of the dental anomalies studied in the general population, we can conclude that palatal maxillary canine impaction, tooth agenesis and upper lateral incisor microdontia are strongly associated with Class II Division 2 malocclusion.

A Novel Approach for Correction of Tooth Transposition

A Novel Approach for Correction of Tooth Transposition

Tooth transposition: A descriptive study in a 547-patient sample

The aim of this investigation was to study the prevalence of tooth transposition in a population of orthodontic patients. A total of 547 patient records from our dentofacial orthopedics department were consulted. Each file included clinical observations, panoramic radiography, lateral cephalograms and dental casts. Patients with incomplete or poorly kept orthodontic records were excluded from the sample, as were those with unreadable panoramic radiographs. The classification of tooth transpositions used in the study was that first proposed by S. Peck and L. Peck in 1995. Computerized statistical analysis was performed using Epi-Info 6.0. The prevalence of tooth transposition was 2%, with the female population more heavily affected (64%). Tooth transposition occurred only in the maxillary arch. Of all the teeth, the canines were the most involved in this anomaly (100%). Transposition was associated with tooth agenesis in 18% of cases, peg lateral incisors in 27%, and persistent deciduous teeth in 18%. The prevalence of tooth transposition in this study population remained low, but was nonetheless higher than that found in most published investigations.

A Novel Approach for Correction of Tooth Transposition

Tooth transposition is defined as the positional interchange of two adjacent teeth within the same quadrant. The new concept of interdisciplinary collaboration between orthodontics and other specialties of dental medicine is best synthesized by the word TEAM (together everyone achieves more). The success of any dental procedure is not considered without careful consideration of other allied branches. Orthodontic correction does not always guarantee a full treatment. Corrective and restorative phases are required to complete the procedure. In this article, we present a case with canine premolar transposition, and its interdisciplinary management with novel restorative procedure.

A retrospective study on 69 cases of maxillary tooth transposition

The published literature on tooth transposition includes only a few studies that have involved more than 50 subjects. The aim of the present study was to investigate the prevalence of true maxillary tooth transposition and possible associated dental anomalies in a larger sample of children. The dental records and radiographs of children who had been diagnosed as having true maxillary tooth transposition at a School Dental Clinic in Hong Kong were studied retrospectively. Data were analyzed for sex and side distribution, as well as for associated dental anomalies. Trends of differences were analyzed statistically using the Fisher exact or chi-squared test. A total of 69 cases of true maxillary tooth transposition were identified and studied; its prevalence in Hong Kong Chinese children was 0.81%. More females than males were affected, and the difference between the sexes was statistically significant (P < 0.05). The prevalence of congenitally missing teeth, microdontia of the maxillary lateral incisors or dental impaction was higher in patients with maxillary tooth transposition than in the general population (P < 0.05, P < 0.0005, and P < 0.0001, respectively). The fact that patients with maxillary tooth transposition were more likely to have congenital absence or microdontia of the maxillary lateral incisors lent further support to the contention that a developmental field defect plays a role in the pathogenesis of maxillary tooth transposition.

Bilateral Maxillary Canine-Premolar Transposition

Tooth transposition is a severe disturbance of tooth order and eruptive position, involving certain teeth that may occur at any of the several sites in the mouth. Maxillary canine-first premolar (MxCP1) transposition is the most frequent tooth transposition. This case report presents the treatment of female patient with bilateral maxillary canine-premolar transposition. The order of transposition was maintained during the treatment.

Transposition of a maxillary canine and a lateral incisor and use of cone-beam computed tomography for treatment planning

This report describes the orthodontic treatment of a 12-year-old girl with transposition of the maxillary left canine and the lateral incisor. Cone-beam computed tomography was used during treatment planning. The transposed tooth positions were corrected with an unconventional orthodontic approach. Treatment alternatives and their clinical concerns are presented.

Transposition: an orthodontist's dilemma—a case report

Tooth transposition presents a major challenge in the correction of a malocclusion. A dental transposition is an uncommon disturbance affecting 0.4% of the population. The treatment difficulties make this anomaly an occurrence of orthodontic interest and a source of clinical interest. The treatment requires a great deal of control and carefully applied mechanics. This case report demonstrates the orthodontic management of the unilateral transposition of a maxillary canine with a premolar and missing bilateral incisors that was treated orthodontically without reversing the transposed tooth positions. The case required combined orthodontic and prosthodontic intervention to achieve acceptable morphologic and esthetic occlusion.

The biomechanical behaviour of the hyalinized periodontal ligament in dogs during experimental orthodontic tooth movement

During orthodontic tooth movement, the mechanical behaviour of the extracellular matrix of the periodontal ligament (PDL) determines the cellular processes involved in turnover of the PDL and alveolar bone. This mechanical behaviour is the basis for finite element (FE) models and FE analyses. Five young adult male beagle dogs were used to test the null hypothesis that the mechanical behaviour of the PDL is identical in normal and hyalinized PDL. Therefore, tooth transposition was measured after standardized force application by super-elastic nickel titanium (NiTi) coil springs, exerting a constant force of 100 cN for 5 hours in both conditions. A rapid transposition during the first few seconds was found. However, it was significantly less for hyalinized than for non-hyalinized PDL. Subsequently, a short-lived creep movement was found for hyalinized PDL, while creep persisted at the non-hyalinized sides (analysis of variance and Tukey's multiple comparisons post hoc tests). The results showed substantial biomechanical differences between hyalinized and non-hyalinized PDL at different time points (Mann-Whitney). This indicates that FE models in the study of long-term orthodontic tooth movement, which are based solely on the characteristics of normal PDL should be reconsidered.

The relationship between the ABO discrepancy index and treatment duration in a graduate orthodontic clinic

To test the hypothesis that there is no relationship between the components of the American Board of Orthodontics (ABO) discrepancy index (DI) and duration of orthodontic treatment. A retrospective review of 732 patient records with permanent dentition was performed. Pretreatment radiographs and casts were used to determine the DI score. Other data collected were total treatment duration, age, sex, ethnicity, and the date fixed appliances were removed. Reliability tests showed substantial agreement between examiners (Cohen's kappa 0.68-0.94). Pearson and Spearman correlation coefficients were used to assess the association between the DI scores and length of treatment. A multiple variable regression analysis was used to determine which variables predict treatment duration (P < .05 significant). There was a significant association between the DI and treatment duration. There was a significant multivariate association for DI components (occlusions, crowding, overjet, cephalometrics, overbite, lateral open bite, and tooth transposition) and treatment duration. The hypothesis was rejected. This retrospective study of university clinical records showed that the average increase in treatment duration was about 11 days for each point increase in total DI score. Treatment duration was differentially increased by various components of the DI: approximately 6.5 months for tooth transposition; approximately 1 month for crowding, overjet, or overbite; approximately 3 weeks for occlusion discrepancies; approximately 2 weeks for lateral open bite; and approximately 5 days for cephalometric discrepancies.

Management of multiple sequelaes in permanent dentition: 3 years follow-up

A 12-year-old patient with multiple sequelaes of permanent dentition due to trauma in primary dentition at the age of 8 months, is presented. Clinical and radiographical examinations revealed aesthetical defects, crown-root malformations (#21), hypoplasia (#12, #22), tooth transposition (#13) and odontoma-like malformation (#11). The performed conservative, endo-surgical and prosthetic treatment to gain back the aesthetic and function is reported.

An association between sella turcica bridging and dental transposition

The aim of the present study was to determine any association between tooth transposition and bridging of the sella turcica, given the evidence of common embryonic origins associated with these structures and a genetic basis underlying these two conditions. Clinical records of subjects demonstrating dental transposition and normal controls were collected from several hospital orthodontic departments and specialist orthodontic practices. All cases and controls were documented with good quality lateral cephalometric radiographs and dental panoramic tomograms (DPTs). The study sample consisted of 21 Caucasian subjects (7 males and 14 females; mean age 14.5 years; SD 2.2 years), demonstrating either maxillary or mandibular dental transposition. The control group, matched for age and gender to the study sample, comprised 70 Caucasians (31 males and 39 females; mean age 13.8 years; SD 1.8 years) without dental anomalies randomly selected from subjects referred for orthodontic treatment within the same departments. The extent of sella turcica bridging was quantified from each profile radiograph using comparative measurement of length and diameter. Sella turcica bridging was found more frequently in subjects diagnosed with dental transposition than in the controls, with the difference being statistically significant [chi-square=7.4; degrees of freedom (df)=2; P=0.025; Fisher's exact test; P=0.042]. The increased frequency of complete and partial bridging of the sella turcica in subjects with dental transposition provides further evidence of a genetic basis to this condition. As calcification and bridging of this region can present during early childhood, it may act as a useful diagnostic predictor of susceptibility to local dental problems.

Correction of a maxillary canine-first premolar transposition using mini-implant anchorage

Transposition is defined as a dental anomaly manifested by a positional interchange of 2 adjacent teeth within the same quadrant of the dental arch. Maxillary canine-first premolar [Mx4-3] transposition is the most frequent tooth transposition reported in the literature. In this case report, an orthodontic correction of a transposition of the maxillary left canine and first premolar with the help of palatally located mini-implant anchorage is described. Esthetic and occlusal evaluations suggested alignment of the transposed teeth to their correct anatomic positions in the dental arch. The clinical result at the end of the treatment was satisfactory. Alignment was obtained, and intercuspation was adequate. Nevertheless, the maxillary canine showed facial recession, probably because it was initially positioned buccally. Supporting tissue was examined after treatment and no alveolar bone damage was observed.

Orthodontic Treatment of a Bilateral Cleft Lip and Palate Patient with Bilateral Tooth Transpositions and Congenitally Missing Teeth

Treatment of patients with a cleft lip and palate can be challenging. A boy, 15 years 11 months old, with a bilateral cleft lip and palate and a convex profile, transposed teeth and congenitally missing teeth was treated by orthodontic treatment. 3 year posttreatment records showed excellent results with good occlusion, facial balance and harmony, and long-term stability.

Transposition of maxillary canines with first premolars: a case study of the orthodontic treatment of two sisters

The uncommon prevalence of transposition of teeth is well documented and described as a multifactorial process. Whilst not fully understood, transposition has been associated with certain dental anomalies and a fundamental genetic aetiology. This paper describes the orthodontic diagnosis and subsequent treatment of two sisters with transposed and impacted canines together with missing lateral incisors.

Brief communication: Additional cases of maxillary canine‐first premolar transposition in several prehistoric skeletal assemblages from the Santa Barbara Channel Islands of California

This article identifies and discusses seven new cases of complete maxillary canine-premolar transposition in ancient populations from the Santa Barbara Channel region of California. A high frequency of this tooth transposition has been previously documented within a single prehistoric cemetery on one of the Channel Islands. A total of 966 crania representing 30 local sites and about 7,000 years of human occupation were examined, revealing an abnormally high prevalence of this transposition trait among islanders during the Early period of southern California prehistory ( approximately 5500-600 B.C.). One of the affected crania is from a cemetery more than 7,000-years-old and constitutes the earliest case of tooth transposition in humans so far reported. The results are consistent with findings by other studies that have indicated inbreeding among the early Channel Islands groups. Together with the normal transposition rates among mainland populations, the decreasing prevalence of maxillary canine-first premolar transposition among island populations across the Holocene suggests that inbreeding on the northern Channel Islands had all but ceased by the end of the first millennium B.C., most likely as a result of increased cross-channel migration and interaction.

Meta-analyses and orthodontic evidence-based clinical practice in the 21 century.

Introduction:Aim of this systematic review was to assess the orthodontic related issues which currently provide the best evidence as documented by meta-analyses, by critically evaluating and discussing the methodology used in these studies.Material and Methods:Several electronic databases were searched and handsearching was also performed in order to identify the corresponding meta-analyses investigating orthodontic related subjects. In total, 197 studies were retrieved initially. After applying specific inclusion and exclusion criteria, 27 articles were identified as meta-analyses treating orthodontic-related subjects.Results: Many of these 27 papers presented sufficient quality and followed appropriate meta-analytic approaches to quantitatively synthesize data and presented adequately supported evidence. However, the methodology used in some of them presented weaknesses, limitations or deficiencies. Consequently, the topics in orthodontics which currently provide the best evidence, include some issues related to Class II or Class III treatment, treatment of transverse problems, external apical root resorption, dental anomalies, such as congenital missing teeth and tooth transposition, frequency of severe occlusal problems, nickel hypersensitivity, obstructive sleep apnea syndrome, and computer-assisted learning in orthodontic education.Conclusions:Only a few orthodontic related issues have been so far investigated by means of MAs. In addition, for some of these issues investigated in the corresponding MAs no definite conclusions could be drawn, due to significant methodological deficiencies of these studies. According to this investigation, it can be concluded that at the begin of the 21st century there is evidence for only a few orthodontic related issues as documented by meta-analyses, and more well-conducted high quality research studies are needed to produce strong evidence in order to support evidence-based clinical practice in orthodontics.

Editor's Comment and Q&A: Patterns of tooth agenesis in patients with Down syndrome in relation to hypothyroidism and congenital heart disease: An aid for treatment planning

Introduction The purposes of this study were to investigate the patterns of tooth agenesis (oligodontia and nonoligodontia), maxillary canine impaction, and tooth transposition in subjects with Down syndrome and to determine whether congenital heart disease and hypothyroidism are parameters in tooth agenesis. Methods The study included 114 patients with Down syndrome. The data were quantified by using standardized records, clinical examinations, panoramic radiographs, and solo roentgenograms. The subjects were differentiated into oligodontia (6 or more teeth missing) and nonoligodontia (5 or fewer teeth missing). Results In these patients with Down syndrome, 59.6% had missing teeth. Those in the nonoligodontia group showed a tendency toward a negative correlation between congenital heart disease and agenesis (P = 0.093; odds ratio = 0.49) but a slight positive correlation between hypothyroidism and agenesis (P = 0.060; odds ratio = 3.71). In the oligodontia group, there was a quantitatively and qualitatively different pattern, indicating another phenotype. When both mandibular central incisors were missing, there was a remarkable chance for oligodontia (P = 0.001; odds ratio = 38.8). In the mandible, symmetrical agenesis of the canines and lateral incisors was more frequent in the nonoligodontia group. Conclusions The oligodontia (with a different phenotype) and nonoligodontia groups had different patterns of agenesis. Maxillary canine impaction was not related to absence of the lateral incisors. Absence of both mandibular central incisors was a high predictor for oligodontia. Congenital heart disease and hypothyroidism are parameters involved in tooth agenesis. The purposes of this study were to investigate the patterns of tooth agenesis (oligodontia and nonoligodontia), maxillary canine impaction, and tooth transposition in subjects with Down syndrome and to determine whether congenital heart disease and hypothyroidism are parameters in tooth agenesis. The study included 114 patients with Down syndrome. The data were quantified by using standardized records, clinical examinations, panoramic radiographs, and solo roentgenograms. The subjects were differentiated into oligodontia (6 or more teeth missing) and nonoligodontia (5 or fewer teeth missing). In these patients with Down syndrome, 59.6% had missing teeth. Those in the nonoligodontia group showed a tendency toward a negative correlation between congenital heart disease and agenesis (P = 0.093; odds ratio = 0.49) but a slight positive correlation between hypothyroidism and agenesis (P = 0.060; odds ratio = 3.71). In the oligodontia group, there was a quantitatively and qualitatively different pattern, indicating another phenotype. When both mandibular central incisors were missing, there was a remarkable chance for oligodontia (P = 0.001; odds ratio = 38.8). In the mandible, symmetrical agenesis of the canines and lateral incisors was more frequent in the nonoligodontia group. The oligodontia (with a different phenotype) and nonoligodontia groups had different patterns of agenesis. Maxillary canine impaction was not related to absence of the lateral incisors. Absence of both mandibular central incisors was a high predictor for oligodontia. Congenital heart disease and hypothyroidism are parameters involved in tooth agenesis.

Patterns of tooth agenesis in patients with Down syndrome in relation to hypothyroidism and congenital heart disease: An aid for treatment planning

The purposes of this study were to investigate the patterns of tooth agenesis (oligodontia and nonoligodontia), maxillary canine impaction, and tooth transposition in subjects with Down syndrome and to determine whether congenital heart disease and hypothyroidism are parameters in tooth agenesis. The study included 114 patients with Down syndrome. The data were quantified by using standardized records, clinical examinations, panoramic radiographs, and solo roentgenograms. The subjects were differentiated into oligodontia (6 or more teeth missing) and nonoligodontia (5 or fewer teeth missing). In these patients with Down syndrome, 59.6% had missing teeth. Those in the nonoligodontia group showed a tendency toward a negative correlation between congenital heart disease and agenesis (P = 0.093; odds ratio = 0.49) but a slight positive correlation between hypothyroidism and agenesis (P = 0.060; odds ratio = 3.71). In the oligodontia group, there was a quantitatively and qualitatively different pattern, indicating another phenotype. When both mandibular central incisors were missing, there was a remarkable chance for oligodontia (P = 0.001; odds ratio = 38.8). In the mandible, symmetrical agenesis of the canines and lateral incisors was more frequent in the nonoligodontia group. The oligodontia (with a different phenotype) and nonoligodontia groups had different patterns of agenesis. Maxillary canine impaction was not related to absence of the lateral incisors. Absence of both mandibular central incisors was a high predictor for oligodontia. Congenital heart disease and hypothyroidism are parameters involved in tooth agenesis.

Early orthodontic treatment of unilateral mandibular left lateral incisor–canine transposition: A Case Report

Among dental anomalies, tooth transposition is considered the most difficult to manage clinically. Distal migration of permanent mandibular lateral incisor happens rarely. It can be discovered radiographically in the early mixed dentition & interceptive treatment is often appropriate. If left uncorrected it may erupt ectopically and the results are often unsatisfactory both esthetically and functionally. When transpositions are detected early the positions of the root apices are important in deciding where to move the transposed tooth. This article reports a case of early orthodontic treatment of a rare unilateral mandibular left lateral incisor - canine transposition.