Unerupted Teeth Research Articles

Clinical and histopathological study of 279 dentigerous cysts in 192 dogs (2012–2022)

Unerupted teeth in dogs are fairly common and may develop an odontogenic cyst that causes destruction of the surrounding bone and affect adjacent teeth. We analyzed histological reports of cysts associated with unerupted teeth in a large population of dogs. Medical records and histopathological results of cysts associated with unerupted teeth were evaluated from all dogs treated at a private referral veterinary dental clinic over a 10-year period (2012–2022). A total of 192 dogs with 279 cysts associated with one or more unerupted teeth were included in the study. Brachycephalic breeds were overrepresented. The most affected were Tibetan Spaniels with 58 dogs (30%) and Boxers with 48 dogs (25%). The most common affected tooth was the mandibular first premolar tooth with 238 (84%) cysts. Of the total of 279 cysts, 208 (75%) were histopathologically examined. None of the cysts examined contained malignant changes. Based on these 208 cysts, the probability of finding a cyst with malignant changes in a population of dogs is 0–1.4% (confidence interval 95%).

A Huge Infected Dentigerous Cyst Occupying the Maxillary Sinus

A dentigerous cyst (DC) ranks as the second most common odontogenic cyst after a radicular cyst arising from the crowns of impacted, embedded, or unerupted teeth. DC frequently causes the corresponding tooth to be displaced into an ectopic location, such as the sinus cavity in the maxilla. Surgical treatment involves extracting the tooth and enucleating the cyst using a conservative intra-oral approach or endoscopic surgery. We report a rare case of a 25-year-old woman with maxillary third molars inside the maxillary sinus attached to a dentigerous cyst and treated with Caldwell Luc surgery through an intraoral approach.

Radiation exposure during orthodontic treatment: risk to children and adolescents.

To estimate radiation risk to children and adolescents during orthodontic treatment by retrieving number and type of radiographs from the patient records. Radiographs, along with justifications for radiation exposure, were obtained retrospectively from the patient records of 1,790 children and adolescents referred to two Swedish orthodontic clinics. Data were grouped according to treatment stage: treatment planning, treatment, and follow-up. Estimated risk was calculated using the concept of effective dose. Each patient had received around seven radiographs for orthodontic purposes. The most common exposures during treatment planning were one panoramic, one lateral, and three intraoral periapical radiographs. A small number of patients received a tomographic examination (8.2%). Few justifications for treatment planning and follow-up, but more in the actual treatment stage, had been recorded. The most common examinations were to assess root resorption and the positions of unerupted teeth, or simply carry out an unspecified control. The estimated risk of developing fatal cancer was considered low. The radiation risk from orthodontic treatment was equivalent to about 5-10 days of natural background radiation. Children and adolescents sometimes undergo multiple radiographic examinations, but despite the low radiation burden, accumulated radiation exposure should be considered and justified in young patients.

Imaging characteristics of gubernaculum tracts in patients with cleidocranial dysplasia: a computed tomography study

ObjectivesTo elucidate the imaging characteristics of the gubernaculum tract (GT) in patients with cleidocranial dysplasia (CCD) as visualized with computed tomography (CT). Study DesignThis was a retrospective analysis of the presence and shape of GTs of unerupted permanent teeth and supernumerary teeth on CT in 9 patients with CCD. ResultsThe overall GT detection rate for unerupted permanent teeth was 83.5% (81/97), with no significant difference between permanent teeth without and with adjacent supernumerary teeth (P=0.414). The overall GT detection rate for unerupted supernumerary teeth was 83.1% (49/59). Of the 156 total unerupted teeth analyzed, 83.3% (130/156) were judged to have GTs. No significant difference in detection rate of GTs was found between permanent and supernumerary teeth (P=1.000). A composite GT morphology consisted of a single tract for a permanent unerupted tooth with one or two supernumerary teeth in which the dental follicles of the permanent and supernumerary teeth were confluent. In total, 44 groups consisted of one permanent and one or two supernumerary teeth; 79.5% (35/44) had GTs. ConclusionsA specific composite structure of GTs and dental follicles may signify that two or three teeth are derived from a single dental lamina in patients with CCD. In such cases, tooth eruption may fail due to the presence of only one GT for multiple teeth.

Bone age and dental late effects in childhood cancer survivors: Radiographic findings in a Brazilian sample.

Changes in bone age and tooth development are late side effects of cancer therapy and can be identified by imaging examination. To evaluate the late effects of antineoplastic treatment on bone age and dental development in childhood cancer survivors. This is a retrospective case-control study on paediatric cancer survivors of both sexes who underwent antineoplastic treatment with 5-15 years of survival. Carpal radiographs were assessed for bone age and growth curve, and panoramic radiographs were used to evaluate dental development and alterations. Carpal radiographs were analyzed using the Greulich and Pyle inspection method, and the Martins and Sakima method was used to analyze the growth curve. All tests were applied with a confidence level of 95%. The study and control groups comprised 28 and 56 patients, respectively. There was no significant difference in bone age and growth curve between the study and control groups. Nonetheless, when sex was compared to chronological and bone ages, there was a significant difference in bone age (p = 0.019) and an underestimation in both groups and sexes in the Greulich and Pyle method. As to late dental effects, dental agenesia, microdontia, gyroversion, and unerupted teeth were found. Dental shape alterations mainly involve the root region. Close multidisciplinary collaboration is necessary during the follow-up period of young patients who have survived cancer.

Regional Odontodysplasia: An Atypical Case Report

Regional odontodysplasia (RO) is an unusual developmental anomaly in which ectodermal and mesodermal tooth components are affected. It is a localized, nonhereditary developmental abnormality of teeth with extensive adverse effects on the formation of enamel, dentin and pulp. This article reviews a case of a 16-year-old male who reported with unerupted maxillary anterior teeth. This case was rare in that it involved maxillary dentition with unerupted maxillary anterior teeth on the right side, but on the left side central incisor was unerupted. Radiographically, the affected teeth had a ‘ghostly’ appearance, showing a marked reduction in radiodensity. Both enamel and dentin appeared to be very thin, the pulp chamber was exceedingly large, and the roots were short with wide open apices. All these characteristics were consistent with the diagnosis of regional odontodysplasia. The affected teeth were surgically removed and prosthetic rehabilitation was provided to the patient.

Pre-eruptive intramural resorption in unerupted teeth: a cone-beam computed tomography evaluation of prevalence and related factors

ObjectivePre-eruptive intramural resorption (PEIR) is defined as an abnormal, well-circumscribed radiolucency within the coronal dentin of the tooth, which is often overlooked in plain radiographs. This study aimed to investigate the prevalence of PEIR and its related factors using cone-beam computed tomography (CBCT).MethodsCBCT images of 590 unerupted teeth were evaluated for the presence of PEIR, location of PEIR, number of lesions in the affected tooth, PEIR score, tooth angulation, tooth position, and pericoronal space. Binary logistic tests were used to analyze the association between the characteristics of PEIR and the patient’s demographic data and related factors.ResultsThe tooth prevalence of PEIR was 13.6% among unerupted teeth. However, it was noteworthy that 19.2% of the unerupted teeth with PEIR were planned to be kept. PEIR was significantly associated with transverse (p = 0.020), inverted-angulated (p = 0.035), and centrally-positioned teeth (p = 0.043). The severity of PEIR was more pronounced in teeth with distal (p = 0.019), lingual (p = 0.023), or inverted-angulated (p = 0.040) positions, and in the absence of pericoronal space (p = 0.036).ConclusionPEIR should be suspected in transverse, inverted-angulated, centrally positioned unerupted teeth, particularly in molars, with no pericoronal space. Further monitoring through CBCT is recommended in such cases.Clinical relevanceThe management of unerupted teeth does not always involve surgical removal. Instead, they could be utilized for artificial eruption or tooth transplantation. The present study emphasizes the significance of early detection of PEIR. Clinical recommendations for screening PEIR in unerupted teeth are also proposed, which can be applied to routine plain radiographs.

Comparison of the different methods of width estimation in unerupted canine and premolars

BackgroundThere are different methods for determining the required space for unerupted teeth. However, the accuracy of these techniques varies depending on ethnic differences. Therefore, the current study was performed to compare the accuracy of four methods for estimating the mesiodistal width of unerupted canines and premolars in a population of northern Iran.MethodsThe present cross-sectional study was conducted on 50 pairs of dental casts of patients aged 12–24 years old. The mesiodistal width of the teeth was measured with a digital caliper by two observers (ICC < 0.9), and the mean value was recorded. The space required for eruption of canines and premolars was obtained by the Tanaka-Johnson formula and the Moyers tables and compared with the actual value by paired t test.ResultsThe Tanaka-Johnson formula had overestimation in the maxilla and mandible, which was statistically significant (p < 0.001). The values obtained from the Moyers tables in different confidence levels were not accurate. However, the 65% level for the mandible had almost no difference from the actual value (P = 0.996 and r2 = 0.503). Furthermore, linear regression was obtained based on the total mesiodistal width of the maxillary first molar and mandibular central incisor (maxilla: Yx= 0.613X + 2.23 and mandible: Ym= 0.618X + 1.6) and the total mesiodistal width of the mandibular first molar and maxillary central incisor in each jaw (maxilla: Yx = 0.424X + 5.021 and mandible: Ym = 0.447X + 3.631).ConclusionThe Tanaka-Johnson method was overestimated in the population of northern Iran. The 85% and 75% confidence levels of the Moyers table have the best clinical results for the maxilla and mandible, respectively. Regression based on maxillary first molars and mandibular central incisors has better results.

A Feasibility Study for a Novel Trans-infraorbital Canal Approach to the Maxillary Nerve in Pigs (Sus domesticus).

Experimental maxillofacial surgery is commonly performed in pigs; however, locoregional anesthesia of this area has not been described. This study evaluated the feasibility of a novel maxillary nerve block approach. In part I, cadavers were used to determine anatomic landmarks and assess maxillary nerve dye staining by using 0.03 mL kg-1 of a 1:10 mixture of commercial food dye and 0.5% bupivacaine. In part II, 10 additional pig cadavers underwent bilateral ultrasound-guided maxillary nerve blocks by using trans-infraorbital canal needle placement. The maxillary nerve was harvested and scored based on degree of staining (0 and 1, absent or incomplete staining; 2, staining; >1 cm circumferentially). Intracranial and intraconal spread of dye was evaluated. A Kruskal-Wallis test was used to compare infraorbital canal length estimated either externally via landmarks, internally via ultrasound, or actually measured after dissection. In 18 of 20 (90%) injections, successful staining (score = 2) of maxillary nerves was obtained for a nerve length of 2.4 ± 0.3 cm. Two of 20 cases (10%) had inadequate staining (score <2). At dissection of these 2 cases, the needle tip was observed to have collided with an unerupted tooth (third molar). No intracranial or intraconal spread of dye was observed. We detected no statistical differences between the estimated external, estimated internal, or actual dissection methods for measurement of infraorbital canal length (P = 0.3). Ultrasound-guided trans-infraorbital maxillary nerve block in pigs is a feasible technique, warranting further work to evaluate its in vivo efficacy and safety.

Prevalence of dentigerous cysts in a Portuguese university clinic population with bone pathology

Objectives: To assess the prevalence and characterize the dentigerous cyst in a Portuguese population with bone pathology and to study the concordance rate between clinical and histological diagnoses of all cases. Methods: Clinical records of patients attending Oral Surgery and Oral Pathology consultations in a Portuguese university clinic between 2000 and 2023 were consulted. Bone pathology cases were selected along with information about sex, age, and anatomic location. The concordance rate between clinical and histological diagnoses was also calculated, dividing the cases into totally concordant, partially concordant, and discordant. Statistical analysis was conducted using chi-square tests. Results: The dentigerous cyst prevalence within bone pathology cases was 10.50%. It was more prevalent in males (68%), with no statistical significance (p&gt;0.05). The average age of patients was 36.9 ± 13.5 years old. About half of the cases (56%) were associated with unerupted teeth, and third molars were the most affected teeth (33.33%). Most cases (57%) were in the mandible, with no statistical significance, more prevalent in the fourth quadrant (38.89%). The clinical diagnosis of 44.80% of the cases analyzed agreed with the histological diagnosis, 17.65% agreed partially, and 37.55% disagreed. Conclusions: The prevalence of dentigerous cysts in the referred population was 10.50%. They were more prevalent in males and mostly located in the mandible, with a higher incidence between 19 and 50 years of age. The concordance rate between clinical and histological diagnoses was 62.45%, a value that can and should be improved.

Tanaka-Johnston’s Mixed Dentition Analysis among Orthodontic Patients in Tanzania

Background: Lower incisors are the first teeth to erupt, their sizes are reliable and little changes occur on the lower arch during mixed dentition. These teeth can be used to predict the size of remaining unerupted teeth. Tanaka Johnston's analysis is the most widely used method of mixed dentition analysis worldwide. The aim of the study was to assess the accuracy of Tanaka-Johnston’s methods of mixed dentition analysis among orthodontic patients in Tanzania. Methods: A cross-sectional study design was carried out at MUHAS dental clinic involving models from orthodontic patients. Data collection involved actual teeth size measurement and prediction using Tanaka-Johnston’s method. Comparison between the actual measurements and the predicted measurements was assessed using students' paired t-tests. Prediction equations for the present study were generated using a simple linear regression analysis. Results: Tanaka Johnston's method significantly overestimated the combined width of upper canines and premolars in the female group (p=0.000). However, the method underestimated the lower jaw measurements in both sexes (p&lt;0.05). New prediction equations for the present study were generated for each sex and arch separately. For the upper jaw, it was Y=11.97+ 0.56X for males and Y = 10.97+0.49X for females. While for the lower jaw, it was Y= 10.8 +0.51X for males and Y=11.39+0.47X for females. Conclusion: Tanaka-Johnston’s methods of mixed dentition analysis was found to be inaccurate in estimating the size of unerupted canines and premolars in the study sample. Therefore, new prediction formulas were generated.

Assessment of dental morbidity in school-going children (6–10-year-old): A cross-sectional study

Background Restricted activity days are prevalent in children with oral health problems. Oral health issues cause over 50 billion hours of education to be lost each year, which has an impact on children’s school performance and the potential for success. Mostly it is concluded that dental caries is the most common disease among individuals. In addition, it may create chronic systemic conditions in healthy individuals. In children, it may induce deformities in the growth of the unerupted teeth. This study will help identify the factors and causes of risk factors for morbidities associated with dental problems. It also includes the educational status and socioeconomic condition of their parents, which is conducted in the Wardha district of Maharashtra in the field practice of villages among children. Aim To Assess dental morbidity among schoolchildren in rural areas and their relationship with their socioeconomic status in rural areas of Wardha District. Methodology A questionnaire-based face-to-face interview was conducted in this community-based cross-sectional study to assess dental morbidity in school-going children. The study participants will be children aged 6–10 years in the rural areas of the Wardha district. The variables of this study were the sociodemographic profile, habits, and morbidities of the children.

The Management of a Geriatric Patient Using Dabigatran Therapy on Dentigerous Cyst with Oral Bleeding.

Jaw cysts represent a great matter of interest in oral and maxillofacial surgery. Jaw cyst surgery is a common intervention in oral surgery but, in the case of a multidisciplinary patient, the oral surgeon needs to meet with other specialists. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts after radicular cysts, and commonly few or no symptoms are reported. However, the most common diagnosis for dentigerous cyst is represented by eruption of the affected tooth or accidental diagnosis. Commonly, dentigerous cysts may be related to impacted third molars; in the case of impacted third molars and a dentigerous cyst, the tooth should be removed along with the cyst in the same intervention. Mandibular dentigerous cysts are common in children and adults, while dentigerous cysts are a rare neoformation in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with the mandibular nerve, and/or the patient has a medical history that may represent a relative or absolute contraindication. We present the case of a rare symptomatic manifestation of dentigerous cyst in an elderly patient in treatment with dabigatran therapy; for the treatment of dentigerous cysts in the elderly, we suggest a multidisciplinary approach with the use of the histological examination and a careful follow-up.

DENTIGEROUS CYST IN CHILDREN: A RARE CASE REPORT

Dentigerous cysts are growths of the jaw's epithelial lining that develop from the dental follicle of unerupted teeth. These cysts are usually found during routine radiography exams, associated with immature teeth. Dentigerous cysts typically don't cause symptoms unless they get big enough to swell. Third, molars and maxillary canines are frequently associated with most dentigerous cysts. A diagnosis is made based on histopathological, radiological, and clinical findings. We describe an instance of a dentigerous cyst that was connected to two immature mandibular premolar teeth. This rare case report discusses the treatment of a dentigerous cyst in the lower premolar region of the left mandible. Under local anesthesia, the patient had surgical treatment that included the removal of two primary teeth and enucleation of the cyst. The evaluation revealed that one week after surgery, the recovery was complete.

Case Report: Management of pediatric Le Fort and mandibular fracture with a modified cap splint

Pediatric facial fractures are rare and make up 5–15% of all facial fractures. The low incidence of facial fractures among children is due to physiological and environmental factors such as greater resilience of the pediatric skeleton, higher bone to tooth ratio, direct parental supervision and limited outdoor activity.1 In children of 5–10 years of age nasal fractures are by far the most frequent (58.6%), followed by mandibular fractures (21.5%). Orbital (9.5%), frontal (5.1%), and midfacial (3.8%) fractures are next in frequency2. Le Fort fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. In the mandible condylar fracture is the most common (38.9%) followed by angle (20.6%), parasymphysis (18.3%), body (15.3%) and symphysis (5.3%).3 Facial fractures are more common in boys, though this varies greatly from 1.1:1 to 8.5:1.4 The majority of facial fractures in children result from falls (7.8–48%) and sports-related injuries (4.4–42%).5 In primary or mixed dentition, the placement of internal fixation hardware is challenging due to the risk of injuring unerupted permanent tooth follicles. The use of resorbable plates and screws offer a potential solution to the growing pediatric facial bone as the standard titanium fixation systems carry the risk of translocation, growth restriction, and dental injury. Dental splinting or suspension wires can also be used in place of direct plating. Fortunately, mild malocclusion at this age has the potential to be improved through bony remodeling, the eruption of permanent dentition, compensation of the mastication mechanism, and posttraumatic orthodontia.6 Accordingly, the goal of treatment is to restore the underlying bony architecture to its preinjury position in a stable fashion with minimal residual functional and esthetic impairment.

Odontogenic lesions associated with impacted teeth: A 5-year retrospective institutional study

Introduction: Odontogenic lesions related to impacted teeth are common findings in routine dental exams, with the potential to cause tooth pain, displacement, bone expansion, or even bone erosion. Thus, their early detection is important. This study aimed to evaluate the frequency of such lesions based on patient age, gender, and location at the Tehran University of Medical Sciences, School of Dentistry, over five years.&#x0D; Materials and Methods: This retrospective study evaluated records from the Oral Pathology Department, covering a five-year period. The association of odontogenic lesions with impacted teeth was assessed. Data on lesion type, patient age and gender, involved jaw, lesion location, and affected teeth were extracted from patient records. Statistical analysis was performed using SPSS 24.&#x0D; Results: Out of 815 odontogenic lesions, 44.4% were associated with impacted teeth. The patient distribution was 52.48% male and 47.52% female. Lesions were most prevalent in the third decade of life (24.58%), and third molars (59.39%) were frequently involved. The posterior mandible (68.5%) and mandibular third molar (55%) were common sites. Dentigerous cysts had the highest frequency (35.4%), with odontogenic cysts (developmental) occurring more frequently (70.7%) than odontogenic tumors.&#x0D; Conclusion: The study underscores a significant association between odontogenic lesions and impacted or unerupted teeth. Periodic follow-ups are crucial for retaining impacted teeth based on these findings.

Dentigerous cysts suspected the other odontogenic lesions on panoramic radiography and CT.

Dentigerous cysts are known as the second most common type of cyst in the jaws. The cyst is one of the lesions occurred frequently in the posterior body of the mandible and is often related to the unerupted third molar and forms around the crown of the unerupted tooth attaching at the cementoenamel junction. Such characteristic appearances are the diagnostic points differentiating from ameloblastoma or odontogenic keratocyst. However, it would be hard for us to diagnose it as a dentigerous cyst if the lesion does not show its typical appearance. We experienced two cases of dentigerous cysts which did not form around the crown of the unerupted tooth on radiologically. Both cysts were relatively large and resorbed adjacent teeth roots. Therefore, an ameloblastoma or an odontogenic keratocyst was suspected rather than a dentigerous cyst as the imaging diagnosis. The biopsy revealed that the lesion was a "dentigerous cyst" in one of the cases and "developmental cyst with inflammation" in another case. After the excision, the histopathological diagnosis was a dentigerous cyst with inflammation in both cases. This report shows the two cases of dentigerous cysts focusing on panoramic radiography and CT images. Also, we discuss the differential diagnosis by reconsidering those diagnostic points.

Coincidence of nasopalatine duct cyst and dentigerous cyst: a rare case report

&#x0D; &#x0D; &#x0D; Dentigerous cyst is one of the most common odontogenic cysts of the jaw that slowly grows around an unerupted tooth crown. Nasopalatine duct cyst is a non-odontogenic common jaw cyst. Co-oc- currence of nasopalatine duct cyst and dentigerous cyst in the same location of the same jaw is ex- tremely rare. Odontogenic and non-odontogenic cysts occurring simultaneously in non-syndromic patients is rare. The lesions must be fully extracted by surgery. We report the treatment procedure of a patient suffering from this rare phenomenon.&#x0D; &#x0D; &#x0D;

Solitary Radiopacity Associated with Root of Unerupted Supernumerary Tooth - A Case Report and Differential Diagnosis

Radiopaque lesions of jaws are innumerable and variable in appearance. There are several radiopaque lesions seen in the periapical region of tooth root which are indistinguishable from other lesions. The diagnosis and management of these lesions from clinical and radiographic features could be challenging to the dentist. Alterations in the bone could be inflammatory cystic odontogenic and non-odontogenic neoplastic reactive vascular traumatic dysplastic or metabolic in origin. As intraoral periapical radiographs IOPA provide the best image resolution they can aid in identifying the subtle changes in the bone architecture periodontal ligament Pdl space and lamina dura. Radiographic analysis of the involvement of adjacent structures using panoramic imaging is not sufficient for diagnosis as it provides 2D imaging of a 3D object. Cone Beam Computed Tomography CBCT provides an accurate 3D image of the involvement of bone and adjacent structures. Systematic radiologic analysis of lesions based on their location size shape borders internal structure effect on surrounding structures and consideration of clinical signs and symptoms enable clinicians to arrive at a reliable diagnosis. Here we present a case report of an asymptomatic radiopaque lesion associated with the root of an unerupted supernumerary tooth which was accidentally detected on an IOPA taken for treating the adjacent tooth.

Adenomatoid odontogenic tumor. Presentation of a clinical case

Adenomatoid odontogenic tumor (ATO) is a rare benign tumor that represents 3% of odontogenic tumors. Originated from remains of the dental lamina or odontogenic epithelium, it occurs in three variants: follicular (73%), extracystic (24%) and intraosseous (3%). The follicular variant is the most common and is usually associated with the crown of an unerupted tooth, typically a maxillary canine. It mainly affects young people in their second decade of life and presents as a painless and slow-growing increase in volume in the anterior maxillary region. In this study, the case of a 16-year-old patient with a follicular variant unicystic TOA in the right mandibular region is presented. A complete enucleation of the lesion, which measured 4 cm, was performed, observing expansion of the external cortex, a close relationship with the included tooth 4.3 and root resorption in adjacent teeth. The diagnosis was confirmed by histopathology, and one year later, the patient showed a favorable evolution, with bone repair and no significant complications. Despite its low incidence, it is crucial to report clinical cases of TOA to improve the understanding of its clinical characteristics, surgical management, and postoperative evolution. In addition, they provide information on the prognosis and possible long-term complications of this odontogenic neoplasm