Enlarged dental follicles, a follicular cyst, and enamel hypoplasia in a patient with Lowe syndrome.
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Delayed development of a bicuspid in the right premolar region of the mandible was observed radiographically in a 16-year-old male patient following surgical removal of a developing odontome. Whilst odontomes are commonly associated with a failure of eruption of permanent teeth, this case was unusual in that there was both failure and marked delay of adjacent permanent tooth germ development, suggesting that the odontome was associated with a regional disturbance of odontogenic tissues in the neonatal period.
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The peculiar dentoorofacial characteristics and 12 years of interdisciplinary management of a patient who was severely intoxicated with the man-made chemical polychlorinated biphenyls (PCBs) are described in this case report. Cephalometric measurements showed that the SNA and SNB angles were reduced but that the developments in height and skeletal maturity were in normal ranges. Gingival hyperpigmentation that was caused by high blood PCB concentration was extremely slow to fade. A cystic mass, diffused trabeculae, and irregular calcification, which were shown on the radiograph and which were caused by high blood levels of PCB, changed gradually. However, the patient had periodontal disease because of horizontal alveolar bone resorption and a deep periodontal pocket, despite good plaque control. After the PCB poisoning the tooth roots were hypoplastic and dilacerated. One root was extracted because of chronic periodontitis. Some teeth were impacted, malposed, or ankylosed.
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The aim of this study was to determine the influence of orthodontic treatment on the pulpal and periodontal condition of 91 transplanted immature third molars. In patients with atrophy of the alveolar process or unfavorable root morphology, transplants had to be placed in extreme rotated or infraoccluded positions. After 3 to 6 months, these transplants were derotated (45 degrees to 90 degrees) to a correct position in the dental arch (derotation group; n = 28) or extruded to the occlusal plane (extrusion group; n = 21). Finally, approximal spaces were closed in both groups. A sample of 42 transplanted third molars with no orthodontic treatment need served as the control group. All transplants were followed clinically and radiologically for a mean period of 4.0 years. With respect to pulpal and periodontal conditions, no significant differences were observed between the control and the extrusion group. In contrast, compared with the control group, transplants in the derotation group had a significantly poorer pulpal and periodontal condition. In the derotated transplants, a significant correlation was detected between pulp necrosis and orthodontic treatment of multi-rooted transplants. This study indicates that orthodontic extrusion and minor lateral movements of autotransplanted immature third molars, as well as rotation of single-rooted third-molar transplants, represent no additional risk to transplant survival. In contrast, rotation of multi-rooted transplants seems to initiate later severance of the vascular and nerval supply to the pulp.
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Skulls of 755 Japanese serow (Naemorhedus crispus) were examined for numerical anomalies of teeth, and these were found in 30 (4.0%) specimens. In addition to supernumerary and congenital missing teeth, embedded teeth were also identified. Supernumerary teeth were found in 10 (1.3%) specimens, congenital missing teeth were found in nine (1.2%) specimens, and embedded teeth were found in 11 (1.5%) specimens. Supernumerary teeth were found among the incisors, the upper and lower premolars, and the lower molars. Based on the appearance of certain tooth classes, their size, and their form, atavism was considered to be a possible cause of the occurrence of some of these teeth. Congenital missing teeth were found at the loci of the lower incisors, canines and P(2). In Japanese serow, there appeared to be a tendency for congenitally missing P(2) as well as P(1). All embedded teeth were found at the locus of P(2). These teeth may have occurred as an intermediate state between normal and congenital missing teeth. Variations in the number of teeth in Japanese serow were concordant with their phylogenetic background. Moreover, although variations in the number of cheek teeth tended to be concentrated in the mesial region of the premolars, the tendency in the incisive region was for teeth to appear mesial as well as distal within an incisor-tooth sequence. These results, which are not in accordance with terminal reduction theory, indicate that the phenomenon of tooth degeneration does not only occur at the end of a tooth row.
We re-examined tooth variation in specimens of the Siberian mole, Talpa altaica, from the collection of the Siberian Zoological Museum and discuss the mechanisms of dental evolution. The number of teeth counted in 1789 specimens ranged from 34 to 47, and supernumerary, absent, and connate teeth were observed. The most frequent tooth anomaly was an absent tooth in the premolar region (200 maxillary first premolars and 190 mandibular third premolars), which does not support Fujita and Kirino's terminal reduction hypothesis in the mandible [Fujita T, Kirino T. Ha No Kaibougaku. 21st ed. Tokyo: Kanehara Publishers Inc.; 1976 (in Japanese)]. Supernumerary teeth were found in premolar rows and in the incisor and molar regions. An maxillary fourth molar, positioned distal to the normal third molar, was thought to result from a genetically programmed atavistic event during the natal stages. Connate teeth were observed only in the premolar rows and were thought to have developed with the fusion of two independent tooth germs. Connate premolars appeared to result from an expression of an incomplete division of tooth germ at an early developmental stage or a reunion of independent tooth germs, based on the morphological similarity of the normal and supernumerary premolars. These extraordinarily frequent tooth anomalies of T. altaica are of much interest both in terms of tooth development and classification.
The skulls of 1195 Japanese serow (Capricornis crispus) from six geographically distinct populations were examined for tooth rotation. Our objectives were to determine tooth rotation patterns in Japanese serows, investigate geographical variation in tooth rotation and examine whether space limitations in the jaw accounted for variations. We then sought to explain the origin of tooth rotation in the Japanese serow. Rotated teeth were found in 131 specimens (62 males, 57 females and 12 unknown gender), with no statistically significant difference between males and females (chi(2)=0.03, P=0.86, d.f.=1). Among the six populations, the frequency of tooth rotation varied from 3.7-32.1% (average 11.0%). Most tooth rotation occurred in the upper third and fourth premolars. The lingual cusp of anomalous teeth was rotated 30 degrees -90 degrees mesially or distally from the buccolingual tooth axis, and the rotation direction differed among populations. However, we found no difference in skull or tooth morphology between normal individuals and those with tooth rotation. Therefore, hereditary factors may be involved in Japanese serow tooth rotation. We concluded that genetic differentiation occurred in the past among local Japanese serow populations isolated in mountainous habitats. Gene frequencies were likely subject to random drift, especially during possible population bottlenecks, when genetic factors could most strongly affect the direction of rotation.
OBJECTIVE: The aim of this study was to characterize the tooth phenotype of CSF-1-deficient op/op mice and determine whether expression of csCSF-1 in these mice has a role in primary tooth matrix formation. DESIGN: Ameloblasts and odontoblasts, isolated from wt/wt frozen sections using laser capture microdissection, were analysed for csCSF-1, sCSF-1 and CSF-1R mRNA by RT-PCR. Mandibles, excised from 8 days op/op and wt/wt littermates, were examined for tooth morphology as well as amelogenin and DMP1 expression using in situ hybridisation. op/opCS transgenic mice, expressing csCSF-1 in teeth and bone using the osteocalcin promoter, were generated. Skeletal X-rays and histomorphometry were performed; teeth were analysed for morphology and matrix proteins. RESULTS: Normal dental cells in vivo express both CSF-1 isoforms and CSF-1R. Compared to wt/wt, op/op teeth prior to eruption showed altered dental cell morphology and dramatic reduction in DMP1 transcripts. op/opCS mice showed marked resolution of osteopetrosis, tooth eruption and teeth that resembled amelogenesis imperfecta-like phenotype. At 3 weeks, op/op teeth showed severe enamel and dentin defects and barely detectable amelogenin and DMP1. In op/opCS mice, DMP1 in odontoblasts increased to near normal and dentin morphology was restored; amelogenin also increased. Enamel integrity improved in op/opCS, although it was thinner than wt enamel. CONCLUSIONS: Results demonstrate that ameloblasts and odontoblasts are a source and potential target of CSF-1 isoforms in vivo. Expression of csCSF-1 within the tooth microenvironment is essential for normal tooth morphogenesis and may provide a mechanism for coordinating the process of tooth eruption with endogenous matrix formation.
Dens evaginatus (DE) is an uncommon dental anomaly, having been well documented since 1925. It occurs primarily in people of Asian descent and is exhibited by protrusion of a tubercle from occlusal surfaces of posterior teeth, and lingual surfaces of anterior teeth. Tubercles have an enamel layer covering a dentin core containing a thin extension of pulp. These cusp-like protrusions are susceptible to pulp exposure from wear or fracture because of malocclusion, leading to pulpal complications soon after eruption. Endodontic intervention of permanent teeth with immature roots is unpredic for inflamed pulps, and leaves a tooth with compromised root structure when treating necrotic pulps. Efforts to ensure root maturity have involved preventive or prophylactic treatment with varying degrees of pulp invasiveness. Treatment options have changed as technology and materials have improved. The goal is to review the literature and pathophysiology regarding DE, and present a new comprehensive treatment regimen, including a truly prophylactic approach without pulpal invasiveness. A case study of a mestizo with DE is documented. Treatment of four affected mandibular premolars exhibiting three distinct diagnostic categories will illustrate various aspects of the treatment protocol presented, and tooth morphology of the anomaly is shown to aid clinical recognition.
Mandibular molars can have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of three mandibular molars with a radix entomolaris or paramolaris, both of which are rare macrostructures in the Caucasian population. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described. Avoiding procedural errors during endodontic therapy demand an adapted clinical approach to diagnosis and root canal treatment.