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PubMed2004

Nasal teeth associated with rhinosinusitis.

Intranasal ectopic dentition is a rare clinical entity. It may be asymptomatic or can be associated with different symptoms. In 25% of the reported cases an association with rhinosinisitis is suspected. The possible pathophysiology, diagnosis and treatment are discussed. Teeth in the floor of both nasal cavities, associated with chronic rhinosinusitis, are reported for the first time, and a new treatment option of endonasal extraction under microscopic control is presented.

Adult↗
PubMed2001

The dental follicle in normally and ectopically erupting maxillary canines: a computed tomography study.

The subjects in the study were children who were X-rayed because of increased risk for resorption following ectopically erupting maxillary canines. One hundred and seven children 9 to 15 years of age with 156 maxillary canines that were erupting ectopically and 58 normally were investigated by computed tomography (CT) to describe the features of the dental follicles of the erupting maxillary canines. Contiguous, transverse CT scans were exposed through the maxilla in the canine region and the width and shape of the dental follicles were registered scan by scan throughout the extension of the follicle. The width and the shape of the dental follicle of the erupting maxillary canine varied greatly. The range of the maximum width, measured from the crown to the periphery of the follicle, was 0.5-7.0 mm, with a mean of 2.9 mm and a 95% confidence interval of 2.7-3.2 mm for the entire sample. No relationship was found between the width or shape of the follicles and sex, age, stage of eruption, inclination of the canine, or width of the dental arch. However, the location of the maxillary canine vis-à-vis the adjacent incisor was significantly associated with the width of the follicle, which indicated that local anatomic conditions might influence the width and shape of the follicle. The dental follicles of the ectopically erupting canines were, on average, wider than those of the normally erupting canines. The 95% confidence interval for the normally erupting canines was 2.3-2.7 mm; for the buccally erupting canines 2.4-4.1 mm; for the lingually erupting canines 2.6-3.0 mm; and for the apically erupting canines in relation to the lateral incisors 2.9-4.1 mm. Canine follicles that were wide but within normal limits did not cause deviations in adjacent teeth. Cystically degenerated dental follicles were found but were indistinguishable on the CT scans from those that had been widened physiologically. The contributions of the studied variables to the variation in the width of the dental follicle of the maxillary canine were analyzed with regression models.

Adolescent↗
PubMed1989

The effect of age at diagnosis on the complexity and outcome of treatment of palatally ectopic canines.

This study examined the records of 218 patients from the 5-year period 1979-1983 who were treated for palatally ectopic canines in the Glasgow Dental Hospital. It tested the hypothesis that there was a relationship between the age of the patient at diagnosis, and the complexity and outcome of treatment. Whilst the age of the patient had no influence on the complexity of the treatment required, it had a significant effect on the outcome since it was related to the number of failed appointments and the likelihood of completing treatment successfully.

Adolescent↗
PubMed1984

Periodontal status following the alignment of buccally ectopic maxillary canine teeth.

Twenty-nine patients who had completed orthodontic treatment to resolve buccal displacement of maxillary canine teeth were examined 2.9 years (mean) after all appliances had been discarded. Thirteen of these patients had unilateral displacement, and sixteen were bilaterally affected. In the unilateral cases only the width of attached gingiva was significantly less than in the controls. In the bilateral cases the same observation was made, but here the gingival index and pocket depth also showed statistically significant increases, although the expression of these values was found to have doubtful clinical significance. Posttreatment periodontal assessment is recommended for these cases.

Adolescent↗
PubMed1995

Discriminant analysis in treatment evaluation of ectopic eruption of the maxillary first permanent molars.

The value of an analytical routine which could be used in the evaluation of clinical studies was assessed. Stepwise discriminant analysis with stepwise selection/elimination was used to reduce the amount of data without losing information before further analyses with canonical discriminant analysis. The purpose of canonical discriminant analysis was to reveal interactions between factors associated with the ectopic eruption of the first permanent molars. Two canonical discriminant functions were used to determine the accuracy of diagnosis and the effect of treatment. This information consisted of variables which were the most important (their ranks) and their single correlations (structure coefficients) to the function itself. This information was interpreted clinically. The coefficients of the canonical discriminant functions can be used for classification purposes. The use of a scatterplot instead of simple classification tables is suggested. The scatterplot was particularly informative on how well the procedure discriminated between groups. A table based on original data is included to allow the reader to test the validity of the findings on cases of his/her own. This multivariate strategy avoids spurious intercorrelations between two or more variables analysed as multiple single factors that has a high risk of erroneous conclusions.

Child↗
PubMed2003

Localizing ectopic maxillary canines--horizontal or vertical parallax?

This study compared the use of horizontal parallax (HP) and vertical parallax (VP) radiography for localizing ectopic maxillary canines (EMCs). The true positions of 43 EMCs were determined using the operative notes and subsequent study models following exposure and eruption. Thirty-four palatal and nine buccal EMCs were included in the study. Six experienced orthodontists examined the radiographs of the EMCs and were asked to localize each EMC using VP and HP on separate occasions. The examiners recorded a diagnosis of 'unsure' in 12 per cent of cases using VP and in 5 per cent of cases using HP. The level of agreement of the diagnoses with the true position of the EMCs was significantly greater for HP. Eighty-three per cent of EMCs were correctly located with HP while only 68 per cent were correctly located with VP (P < 0.05). The diagnostic sensitivity for palatally placed canines was significantly greater for HP (88 per cent) than for VP (69 per cent). Both techniques performed poorly when used to localize buccal EMCs, with HP and VP each having a sensitivity of only 63 per cent. It is concluded that HP is superior to VP in diagnostic accuracy, and that two peri-apical radiographs or one peri-apical and one anterior occlusal radiograph are the radiographs of choice for localizing EMCs.

Adolescent↗
PubMed1998

Apparently new syndrome of sensorineural hearing loss, retinal pigment epithelium lesions, and discolored teeth.

We report on a family with early-onset sensorineural hearing loss, abnormal retinal pigment epithelium granularity, accumulation of creamy-white lesions at the level of the retinal pigment epithelium particularly superior to the arcade, and selective discoloration (brown) of molars or canine deciduous teeth that follows an apparent autosomal recessive inheritance pattern. This appears to be a new syndrome that can be distinguished from the known otodental, oculo-acoustic and flecked retina syndromes by the occurrence of distinct dental and ocular abnormalities.

Child, Preschool↗
PubMed1992

Possible relationship between ulnar-mammary syndrome and split hand with aplasia of the ulna syndrome.

We describe a 3-generation family in which mother, maternal grandfather, and 2 (male and female) children have variably manifestations of the ulnar-mammary syndrome, including ulnar ray defects, obesity, hypogenitalism, delayed puberty, hypoplasia of nipples and apocrine glands, and a previously undescribed ectopia of upper canines. The index patient also had split-hand appearance on the right due to complete absence of the 4th ray. To our knowledge this is the first documented example of split hand in the ulnar-mammary syndrome. The hand anomaly raises the question of a possible causal relationship between ulnar-mammary syndrome and the split hand with aplasia of the ulna syndrome, as already hypothesized by Lenz [1980].

Abnormalities, Multiple↗
PubMed1992

Maxillary canine/third premolar transposition in a prehistoric population from Santa Cruz Island, California.

Canine/premolar transposition is rare in both historic and prehistoric Homo sapiens with a known occurrence of less than 0.10%. This report describes a prehistoric population sample from one site (SCrI-3) on Santa Cruz Island, California in which the rate of C/P3 transposition is greater than eight percent, based on nine of 106 adult crania which exhibit the anomaly either uni- or bilaterally. As a means of investigating the etiology of this anomaly, the location of the canine root in adult crania was studied. Root location should indicate tooth bud origin, a factor likely to be under genetic control. In crania with normally erupted canines, the superior portion of the root averages 4.43 mm from alare, while this distance is 8.96 mm for anomalous roots. This difference suggests that during ontogeny the tooth buds for the canine and premolar arose in the wrong (or reversed) places, causing the teeth to erupt anomalously. It is suggested that inbreeding in a small island community resulted in a short-lived appearance of this anomaly at a high frequency.

Bicuspid↗
PubMed2003

Maxillary canine displacement and genetically determined predisposition to disturbed development of the dentition.

BACKGROUND: The relationship between maxillary canine displacement and the simultaneous occurrence of "genetically determined predisposition to disturbed development of the dentition" as defined by Hoffmeister was investigated in 675 patients. PATIENTS AND METHODS: Panoramic radiographs taken of each patient during the first and the second mixed dentition periods were evaluated. Canine inclination and the distance between the tip of the canine and a line connecting the cusps of the molars were computed in five different age groups according to Dausch-Neumann. RESULTS: Statistical analysis revealed 34 patients with "potential canine displacement", who exhibited further symptoms of "genetically determined predisposition to disturbed development of the dentition" significantly more frequently than the total group. The symptoms concerned were agenesia, displaced tooth buds, rotated or tilted incisors, aplasia and microdontia of lateral incisors. CONCLUSION: Careful follow-ups in patients with a predisposition to disturbed dental development enables risks to be anticipated and canine displacement to be detected at an early stage.

Child↗
PubMed2003

Dental anomalies as a microsymptom of palatal canine displacement.

AIM: A retrospective study was performed to investigate whether palatal canine displacement is associated with other dental features permitting early clinical diagnosis of the eruption disturbance. PATIENTS AND METHODS: The study was based on the complete records of 235/8556 patients at the Department of Orthodontics, School of Dental Medicine, University of Freiburg i.Br. (mean age = 14.11 years) with at least one palatally displaced permanent canine. These patients were examined for ten different morphologic parameters, e.g. impaction and congenital absence of further teeth, hypoplastic, peg-shaped, rotated and congenitally missing upper lateral incisors, supernumerary teeth, Angle classification, and cover-bite (= "Deckbiss"). The data were compared with those of a control sample of the same size with physiologic upper canine eruption (mean-age = 10.0 years). Furthermore, in a right/left comparison the local influence of anomalies of the upper lateral incisors on palatal canine displacement was evaluated by multiple linear regression analysis. RESULTS: The statistical analyses revealed that the risk of palatal canine displacement was significantly higher in patients with hypoplasia, peg shape or congenital aplasia of upper lateral incisors, further impacted and congenitally missing teeth and cover-bite. The intergroup differences in terms of gender, rotation of upper lateral incisors and Angle classification were not statistically significant. The right/left comparison revealed a significantly higher risk of palatal canine displacement in association with an adjacent hypoplastic or peg-shaped lateral incisor and with aplasia of the contralateral upper incisor. CONCLUSION: The clinical significance of the study is that the occurrence of palatally displaced canines is often closely linked with other dental anomalies. In this context, anomalies of upper lateral incisors, aplasia or impaction of further teeth, and the anomaly of cover-bite may serve as indicators of palatal canine displacement. A retarded development of the upper lateral incisor seems to be more disturbing for physiologic canine eruption than aplasia. In patients exhibiting the stated microsymptoms, close clinical follow-up of the maxillary permanent canine eruption during the late exfoliation period is strongly recommended.

Adolescent↗
PubMed2005

Investigation of maxillary tooth sizes in patients with palatal canine displacement.

AIM: The aim of this retrospective trial was to investigate differences in mesiodistal and vestibulo-oral crown sizes of naturally, fully-erupted permanent maxillary teeth between patients with and without palatal canine displacement. PATIENTS AND METHOD: 115 patients (mean age: 14 years 10 months; females: 77 males: 38) treated in the Department of Orthodontics, University of Munich were included in the study. 65 of the patients showed at least one palatally-displaced canine. Diagnosis and the location of the displacement were determined on the basis of standardized radiographs and confirmed by surgical documentation. Each maxillary tooth's mesiodistal and vestibulo-oral width was measured using a dial caliper on each dental cast. Excluded were partially-erupted teeth and surfaces with caries or restorations that had to be measured. An analysis of available space was made by evaluating the pre-treatment dental casts of all patients included in the study. RESULTS: Comparing the tooth widths of patients with unilateral canine displacement with the corresponding contralateral quadrants, we noted a statistically significant difference, namely that the central and lateral incisors and the canines of the affected side were narrower than those of the non-affected side in the same patient. Moreover, the displaced upper canines showed an increase in vestibulo-oral dimension. Overall tooth width (including all tooth groups) in patients with palatally-displaced canines was significantly less than that in the control group. However, when comparing the crown diameters of unilaterally- and bilaterally-affected patients, no differences in tooth-size were observed. The space-analysis showed excessive dental-arch space in patients with a palatally-displaced canine. CONCLUSION: Patients affected by palatal canine displacement showed significantly smaller maxillary tooth size.

Adolescent↗
PubMed2006

Wisdom tooth eruption secondary to localized lower molar mesialization in patients with aplastic lower second premolars.

OBJECTIVE: After localized space closure in the mandible it is desirable to preserve lower wisdom teeth as natural replacements for missing second premolars and as antagonists for upper second molars. The aim of this study was to determine whether this treatment method can obviate the need for prosthodontic restorations, implants, and third molar osteotomy. Furthermore the time point of possible third molar eruption was to be determined and whether further orthodontic interventions were required to achieve their alignment. PATIENTS AND METHODS: The test group comprised 34 patients who exhibited agenesis of one or both lower second premolars (n = 45) in conjunction with a corresponding number of third molar tooth germs. Follow-up examinations were performed 2 to 8 years after conclusion of orthodontic treatment involving push-and-pull mechanics (PPM) without extraction of any contralateral teeth. The results of the clinical retrospective follow-up examination at consecutive post-treatment endpoints were compared with two orthodontic control groups (A: 4-premolar extraction group, B: non-extraction group). RESULTS: After an average of 4 years and 2 months, the percentage of fully-erupted third molars in the agenesis group with localized space closure was 82%, compared to 29% and 28%, respectively, in the controls. These differences were statistically significant (p < or = 0.01). The success rate in the agenesis group reached 94% when the 4- to 8-year results were considered in isolation. Compared with the contralateral (non-aplastic) side, teeth on the aplastic side erupted prematurely. In 9% of the cases, minor orthodontic interventions were required to exactly position the third molars. CONCLUSION: There is high probability that mandibular third molars can be preserved after localized space closure, obviating the need for prosthodontic restorations, dental implants, and third molar osteotomies.

Adolescent↗