Risk of developing palatally displaced canines in patients with early detectable dental anomalies: a retrospective cohort study

ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.

Prevalence of mesiodens in orthodontic patients with deciduous and mixed dentition and its association with other dental anomalies

OBJECTIVE: To determine the prevalence of mesiodens in deciduous and mixed dentitions and its association with other dental anomalies. MATERIAL AND METHODS: Panoramic radiographs of 1,995 orthodontic patients were analyzed retrospectively, obtaining a final sample of 30 patients with mesiodens. The following aspects were analyzed: gender ; number of mesiodens; proportion between erupted and non-erupted mesiodens; initial position of the supernumerary tooth; related complications; treatment plan accomplished; and associated dental anomalies. The frequency of dental anomalies in the sample was compared to reference values for the general population using the chi-square test (c²), with a significance level set at 5%. RESULTS: The prevalence of mesiodens was 1.5% more common among males (1.5:1). Most of the mesiodens were non-erupted (75%) and in a vertical position, facing the oral cavity. Extraction of the mesiodens was the most common treatment. The main complications associated with mesiodens were: delayed eruption of permanent incisors (34.28%) and midline diastema (28.57%). From all the dental anomalies analyzed, only the prevalence of maxillary lateral incisor agenesis was higher in comparison to the general population. CONCLUSION: There was a low prevalence of mesiodens (1.5%) in deciduous and mixed dentition and the condition was not associated with other dental anomalies, except for the maxillary lateral incisor agenesis.

OBJETIVO: determinar a prevalência de mesiodens nos estágios de dentição decídua e mista, e verificar sua associação com outras anomalias dentárias. MÉTODOS: radiografias panorâmicas de 1.995 pacientes ortodônticos foram analisadas retrospectivamente, obtendo-se uma amostra de 30 pacientes com o mesiodens. Os seguintes aspectos foram analisados: distribuição entre os sexos, número de mesiodens; se irrompido ou não irrompido; posição; complicações; tratamento instituído, e anomalias dentárias associadas. A frequência de anomalias dentárias na amostra estudada foi comparada a valores de referência para a população em geral por meio do teste qui-quadrado (c²), com um nível de significância de 5% (p < 0,05). RESULTADOS: a prevalência de mesiodens foi de 1,5%, sendo mais comum no sexo masculino (1,5:1). A maior parte dos mesiodens estavam não irrompidos (75%) e numa posição vertical, voltada para a cavidade bucal. O tratamento mais empregado foi a exodontia. As principais complicações associadas ao mesiodens foram o atraso na erupção dos incisivos permanentes (34,28%) e diastema mediano (28,57%). Pacientes com mesiodens não apresentaram prevalência aumentada de microdontia, agenesia de dentes permanentes ou outros supranumerários. De todas as anomalias analisadas, apenas a prevalência de agenesia de incisivo lateral superior mostrou-se aumentada em comparação à população em geral. CONCLUSÃO: o mesiodens foi encontrado em uma prevalência baixa (1,5%) nas dentições decídua e mista, e não apresentou associação com outras anomalias dentárias, com exceção da agenesia de incisivo lateral superior.