Dental anomalies in 14 patients with IP: clinical and radiological analysis and review
Fernanda D. Santa-MariaLuiza Monteavaro MariathCláudia Schermann PoziomczykMárcia Angélica Peter MaahsRafael Fabiano Machado RosaPaulo Ricardo Gazzola ZenLavínia Schüller-FacciniAna Elisa Kiszewski
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Keywords:
Agenesis
Dental anomalies
Incontinentia Pigmenti
Agenesis
Dental anomalies
Incontinentia Pigmenti
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SUMMARYTooth agenesis is the absence of one ormore teeth in temporary or permanent dentition.This anomaly in craniofacial malformationsis more frequent, that may occur asan isolated anomaly or as part of a geneticsyndrome. The incidence of agenesis ofpermanent teeth varies1.6-9.6%, excludingthird molars, while in primary dentition therange is 0.5 to 0.9%. The factors that arerelated to dental agenesis, are the genes andsignaling pathways. Specifically Pax9 hasbeen associated with the lack of permanentmolars. Agenesis of the first and secondpermanent molars is not very commonbut has been reported in the literature andcan be isolated or causing malocclusion.Therefore, early diagnosis is essential toestablish a treatment plan to help guide theeruption of other teeth and prevent sequeldue to agenesis. Four clinical cases are presentedof patients with agenesis of first andsecond permanent molars to complementthe literature review.Key words: Dental agenesis, first permanentmolars, second permanent molars,malocclusion, organogenesis defect.
Agenesis
Permanent dentition
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Past caries experience remains the most powerful predictor of future caries. This study was aimed at exploring the possible relationship between the caries statuses at 3-5 and 8-10 years of age and examining the predictive power of caries experience at 3-5 years of age for the caries pattern at 8-10 years of age.A total of 76 children (43 boys and 33 girls) were included in this study from 2012 to 2018. The first caries examination, performed in 2012, was completed when participants underwent dental rehabilitation under general anesthesia at 3-5 years of age. Tooth decay was recorded based on the International Caries Detection and Assessment System criteria. The caries examination was repeated in the clinic in 2018 when the participants were 8-10 years old. Associations between the permanent and primary teeth were analyzed using the Mann-Whitney U test. The receiver operating characteristic curve analysis was performed to determine the predictive accuracy of the primary dentition.A significant dmfs score of the primary second molar was found between groups of free dentin caries and dentin caries of the permanent first molars (p = 0.002). The calculated areas under the receiver operating characteristic curve for the dmfs score of the primary second molar was 0.74.Caries in the primary second molars is a clinically useful predictor at 3-5 years of age for future dentin caries development on surfaces of the first permanent molars in the following 5 years.
Permanent dentition
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The aim of this study was to develop a new classification of carious incidence patterns in children. The subjects were 702 children aged 18/19 months and 378 aged 24/25 months. The children's teeth were examined and they were grouped by their carious tooth types at 40/41 months of age the mean dmft and mean dmfs were compared between groups. The following results were obtained.The children with caries at the age of 18/19 months could be divided into two classes, i. e., children who had carious teeth in only upper anteriors (class 1-A) and those who had carious teeth in molars or lower anteriors (class 1-B). The children with caries at the age of 24/25 months could be divided into four classes, i. e., children who had carious teeth in only the upper incisors or lower molars (class 2-A), those who had carious teeth in the upper cuspids or upper molars but not in the lower anteriors (class 2-B), those who had carious teeth in the lower incisors but not in the lower cuspids (class 2-C), and those who had carious teeth in the lower cuspids (class 2-D).When the classifications were applied and the carious scores compared between classes at the age of 40/41 months, the children of class 1-A had statistically lower carious scores than those of class 1-B. The children of class 2-A had the lowest carious scores, and those of class 2-B, class 2-C, and class 2-D had significantly more carious teeth in ascending order.From these results, we suggest that the newly proposed carious incidence patterns of children aged 18/19 months or 24/25 months is useful for predisting the caries prevalence at the age of 40/41 months.
Permanent dentition
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To explore a possible relationship between the caries experience and pattern in the primary dentition at 5 years of age and the permanent dentition at 10 years of age. Further, to examine the possibility of predicting children in a caries-risk group at 5 years verified at 10 years of age.A sample of 186 children (90 males) were clinically examined as 5-year-olds and re-examined as 10-year-olds by calibrated dentists. A five-graded diagnostic system including enamel caries was used. Bitewing radiographs were taken. A true risk group of children at 10 years were defined as those with at least one dentin or filled lesion on the mesial surface of 6-year molars, and/or on incisors, and/or total DMFS (decayed, missing, and filled surfaces) more than 1 SD above the mean. The prediction was measured in terms of OR (odds ratio), sensitivity/specificity, and receiver operating characteristic curves.Statistically significant correlations (r=0.5) were found between the caries experience in the two dentitions as well as between the primary second molars at baseline and the permanent teeth at 10 years. 'Primary second molars' and 'all primary molars' were the most powerful predictors for allocation into the risk group (24% of the sample). The highest achieved sum of sensitivity and specificity, 148%, was attained at a cut-off point above two carious surfaces in enamel and/or dentin in primary second molars.Statistically significant relationship in disease between the dentitions was found. More than two surfaces with caries experience in primary second molars are suggested as a clinically useful predictor at 5 years of age for being at high risk at age 10.
Permanent dentition
Carious lesion
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It is claimed that dental fluorosis in both deciduous and permanent teeth is increasing in fluoridated and non-fluoridated communities. What is unclear is whether fluoride-induced enamel opacities in the deciduous dentition are associated with the subsequent appearance of enamel defects in the permanent dentition. The aim of this study was to establish whether a relationship existed between the presence of diffuse enamel defects on the deciduous molars and permanent incisors of schoolchildren who were lifetime residents in an optimally fluoridated community in Cheshire, England. The dentitions of eight-and nine-year-old children were examined by two examiners, each unaware of the findings of the other. There was a significant increased risk of diffuse enamel defects in the permanent incisors for those children who presented with diffuse defects on their first deciduous molars (Relative Risk, 1.45; 95% confidence interval, 1.05 to 2.0) or second deciduous molars (Relative Risk, 1.86; 95% confidence interval, 1.36 to 2.54). In light of these findings, it is worth considering the potential of the presence of enamel defects in deciduous molars in children aged 1 to 3 years as a predictor of the future appearance of similar lesions in their permanent incisors.
Deciduous dentition
Permanent dentition
Deciduous tooth
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Background The number of teeth in the human dentition is of interest both from developmental and evolutionary aspects. The present case-control study focused on the formation of third molars in modern humans aiming to shed more light on the most variable tooth class in the dentition. Materials and Methods For this reason, we investigated third molar formation in a sample of 303 individuals with agenesis of teeth other than third molars (agenesis group) and compared it to a sex and age matched control group of 303 individuals without agenesis of teeth other than third molars. Results The prevalence of third molar agenesis in the agenesis group was 50.8%, which is significantly higher than the 20.5% in the control group ( p < 0.001). The chance of a missing third molar in the agenesis group was increased by 38.3% ( p < 0.001), after controlling for the agenesis in other teeth factor. When considering the amount of missing third molars per individual, a clear tendency towards more missing third molars was evident in the agenesis group compared to the control group. The frequency of bilaterally missing third molars in the agenesis group was 29% in the maxilla, as well as in the mandible, which is about three times higher than the frequency of unilaterally missing third molars ( p < 0.001). In the control group, bilaterally missing third molars occurred in 8.6% in the maxilla and 8.9% in the mandible. Conclusion The present results indicate that genetic factors involved in tooth agenesis affect also the dentition as a whole. Furthermore, the third molars are more vulnerable to factors involved in agenesis of other teeth and they are more often affected as a whole. These findings seem to be associated with the evolutionary trend in humans towards reduced molar number.
Agenesis
Mandible (arthropod mouthpart)
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The mesial surface of the first permanent molar is the most caries-susceptible proximal surface of the permanent dentition in children under the age of 12.The aim of this study was to determine the association between caries progression on the mesial surface of the first permanent molar (T6M) and caries on the distal surface of the primary second molar (t5D) and the occlusal surface of the first permanent molar (T6O).Children (between 5 and 13 years old; N = 565) that had participated in a 4-year longitudinal caries study that at baseline had at least one T6 fully erupted with a t5 in proximal contact, with no restoration or sealant on T6O and t5D, and adequate bitewing radiographs were included. Clinical data using the International Caries Detection and Assessment System (ICDAS) and radiographs were used to determine the caries status of T6M, T6O, and t5D.Baseline caries presence on t5D and T6O were highly significantly associated with follow-up caries presence on T6M (P < .001). The adjusted odds ratios corresponding to t5D and T6O were 3.94 (95% CI: [1.78, 8.71]) and 3.26 (95% CI: [1.46, 7.31]), respectively.These findings highlight the need for prevention and management of caries on T6O and t5D.
Permanent dentition
Tooth surface
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Caries has traditionally been assessed with WHO criteria including only obvious caries lesions. ICDAS has been developed to detect also the enamel caries lesions. This study aims to study caries and the associations of the number of caries lesions between the permanent and primary molars with ICDAS in the mixed dentition of the first and second grade primary school children. The clinical examinations of 485 children were conducted by four examiners with high reproducibility (inter- and intraexaminer kappas >0.9). The mean number of caries lesions—especially dentine caries—seemed to be higher in the second primary molars than in the first permanent molars. There were significant correlations between the number of lesions on occlusal and lingual surfaces between the primary and permanent molars. Enamel caries lesions, restorations, and caries experience did not increase according to age. Therefore, caries might be increasing in this population. As a conclusion, ICDAS recording seems to give appropriate information from the occurrence of caries lesions and its correlations between the primary and permanent teeth and surfaces.
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To investigate the prevalence and incidence of dental erosion in children and adolescents.Lesions were registered for all tooth surfaces of primary and permanent teeth using pre-orthodontic study models. A total of 1,000 individuals (mean age 11.4+/-3.3 years) were included; 265 of them were followed over a 5-year period using their final orthodontic casts.In the primary teeth, 26.4% of the individuals had no erosive lesions, 70.6% had at least one tooth with grade 1 erosion and 26.4% had grade 2 erosion. Grade 1 erosion was found in 44% of the occlusal surfaces of molars (36% of the incisal surfaces of the canines) and grade 2 erosion in 11% (9%). Lesions affecting oral or vestibular surfaces were negligible. In the permanent teeth, 11.6% of individuals had at least one tooth with grade 1 erosion but only 0.2% had at least one tooth with grade 2 erosion. The most affected teeth were the mandibular first molars (7% with grade 1 lesions). Lesions affecting oral or vestibular surfaces were negligible. Mandibular first molars were identified as possible marker teeth for the onset of erosive lesions. Within the last two decades, the percentage of subjects with at least one tooth with a grade 1 or 2 erosive lesion significantly increased for primary and with grade 1 for permanent teeth (P< or =0.001). The longitudinal observation revealed that subjects with erosive lesions in their primary dentition had a significantly increased risk for erosion in their permanent teeth (P< or =0.001).In Germany, dental erosion seems to be a significant, but not a serious, problem for dental health in adolescents.
Tooth Erosion
Tooth wear
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