Multivariate analysis of factors affecting presence and/or agenesis of third molar tooth.

To investigate the presence and/or agenesis of third molar (M3) tooth germs in orthodontics patients in Malaysian Malay and Chinese population and evaluate the relationship between presence and/or agenesis of M3 with different skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. Pretreatment records of 300 orthodontic patients (140 males and 160 females, 219 Malaysian Malay and 81 Chinese, average age was 16.27±4.59) were used. Third-molar agenesis was calculated with respect to race, genders, number of missing teeth, jaws, skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. The Pearson chi-square test and ANOVA was performed to determine potential differences. Associations between various factors and M3 presence/agenesis groups were assessed using logistic regression analysis. The percentages of subjects with 1 or more M3 agenesis were 30%, 33% and 31% in the Malaysian Malay, Chinese and total population, respectively. Overall prevalence of M3 agenesis in male and female was equal (P>0.05). The frequency of the agenesis of M3s is greater in maxilla as well in the right side (P>0.05). The prevalence of M3 agenesis in those with a Class III and Class II malocclusion was relatively higher in Malaysian Malay and Malaysian Chinese population respectively. Using stepwise regression analyses, significant associations were found between Mx (P<0.05) and ANB (P<0.05) and M3 agenesis. This multivariate analysis suggested that Mx and ANB were significantly correlated with the M3 presence/agenesis.

Agenesia del tercer molar en pacientes atendidos en la clínica odontológica de la Universidad de Antofagasta, Chile / Third molar agenesis in patients of dental clinic of the Universidad de Antofagasta, Chile

Se define agenesia como la ausencia de dientes por alteraciones genéticas aisladas o sindrómicas. La agenesia del tercer molar está asociada a malformaciones y es considerada por diversos autores, consecuencia de la evolución humana (Larmour et al., 2005). Son los dientes con mayor prevalencia de agenesia junto con segundos premolares e incisivos laterales (Fuller & Denehy, 1984). La prevalencia varía entre 9% y 37% (McNamara & Foley, 2006); Arboleda et al. (2006) señalan una prevalencia del 20%. La literatura indica variables estadísticas porcentuales, por género, por arcada dentaria, por lado y por diente, con escasos artículos sobre grupos originarios de Chile. La población en estudio consistió en 52 hombres y 48 mujeres, de 14 a 26 años de edad, pacientes de la Clínica Odontológica de la Universidad de Antofagasta. Todos los individuos eran sanos, sin ninguna malformación general o maxilofacial, no habían presentado enfermedades infecciosas que afectaran la odontogénesis y los períodos de erupción dentarios, sin exodoncias de ningún tercer molar y tratamiento ortodóncico previo al examen radiográfico panorámico. Se determina un 20,0% de casos de agenesia, con 8,25% de agenesia, respecto a número total de terceros molares y 1,03% de agenesia de terceros molares en relación al total de dientes. No se determina ninguna diferencia estadística significativa al 95% de confianza, predominando la agenesia en el género femenino, a nivel maxilar, en el lado izquierdo, de tipo simple, siendo el tercer molar superior izquierdo el diente que presenta el mayor número de casos de agenesia.

Agenesis is defined as the absence of teeth by genetic alterations isolated or syndromic. Agenesis of third molar is associated to malformations and is considerate by diverse authors as a consequence of human evolution (Larmour et al, 2005). The third molars are teeth with higher prevalence of agenesis together with seconds premolars and lateral incisive (Fuller & Denehy, 1984). The prevalence varies between 9 percent to 37% (McNamara & Foley, 2006). Arboleda et al. (2006) indicated a prevalence of 20%. The literature notes statistical variables percentage by gender, dental arch, side, and tooth, with few articles on groups originating from Chile. The population in study consisted of 52 men and 48 women between 14 and 26 years old, patients of the dental clinic of the Universidad de Antofagasta. All individuals were healthy, without any general or maxillofacial malformation without infectious diseases affecting the odontogenesis and dental eruption, without extractions of third molar and orthodontic treatment prior to the panoramic x-ray. A 20% of individuals with agenesis was determined, with 8.25% of agenesis respect the total number of third molars and 1.03% agenesis respect the total number of teeth. Statistical analyses did not show significant differences at 95% level, with agenesis of third molar prevalence in females, in maxilla, in the left side, simple, being the left maxillary third molar the tooth that present many number of agenesis.

Agenesia del tercer molar en una etnia originaria del Norte de Chile: atacameños o Lican Antai / Third molar agenesis in native ethnia from north of Chile: atacamenos or Lican Antai

Agenesia es la ausencia de dientes por alteraciones genéticas aisladas o sindrómicas. La agenesia del tercer molar está asociada a malformaciones y considerada por diversos autores consecuencia de la evolución humana (Larmour et al., 2005). Son los dientes con mayor prevalencia de agenesia junto a los segundos premolares e incisivos laterales (Fuller & Denehy, 1984). La prevalencia varía entre 9 y 37 por ciento (McNamara & Foley, 2006), en tanto, Arboleda et al. (2006) señalan una prevalencia del 20 por ciento. La literatura señala variables estadísticas porcentuales, por género, por arcada dentaria, por lado y por diente, con escasos artículos sobre grupos originarios de Chile. La población en estudio consistió en 33 hombres y 57 mujeres de 16 a 55 años, de la etnia atacameña, sin exodoncias del tercer molar ni tratamientos ortodónticos y sin malformaciones congénitas. Se determinó el grado de mestizaje mediante técnica serológica de hemo-aglutinación y por aplicación de la fórmula de Bernstein, que demostró 56 por ciento de mezcla indígena. A cada individuo se le tomó radiografía panorámica para observar presencia o ausencia de terceros molares. Se determina un 26,7 por ciento de individuos con agenesia de uno o más terceros molares, con mayor porcentaje en hombres. En la muestra y en hombres hay mayor agenesia de terceros molares mandibulares; en cambio, en mujeres existe mayor agenesia de terceros molares maxilares. Predominan agenesias izquierdas, lo mismo se comprueba en mujeres, mientras en hombres se comprueba igual porcentaje bilateral. Predomina la agenesia de dos molares en ambos sexos. No existen diferencias estadísticas significativas al 95 por ciento y los resultados coinciden con la literatura. La investigación representa un aporte a la antropología del Norte de Chile, pero considerando lo reducido de la muestra, no fue posible determinar variables étnicas.

Agenesis is the absence of teeth by genetic alterations, single or as syndrome. Agenesis of third molar is associated to malformations and is considered by diverse authors a consequence of the human evolution (Larmour et al., 2005). The third molars together with second premolars and lateral incisors are the teeth with greater prevalence of agenesis (Fuller & Denehy, 1984). The prevalence varíes between 9 percent and 37 percent (McNamara & Foley, 2006); Arboleda et al. (2006) indicated a prevalence of 20 percent. Literature indicate variable percentage, by gender, dental arches, side and tooth, with few arricies on original groups of Chile. The population in study consisted of 33 men and 57 women between 16 and 55 years of the ethnic group of atacameños, without extractions of third molar ñor orthodontic treatments and without congenital malformations. Hybridism was determined by means of serum technique by blood agglutination and by application of the formula of Bernstein, demonstrated a 56 percent of indigenous mixture. To each individual a panoramic x-ray was taken to observe presence or absence of third molars. A 26.7 percent of individuals with agenesis of one or more third molars was determined, with greater percentage among males. Agenesis lower third molar predominates in the sample and in men; however in women are greater agenesis upper third molar. In addition, agenesis predominates of the left side in both sexes, while in men equal bilateral percentage is verified. Agenesis of two molars predominates in both sexes. Statistical analyses did not show significant differences at the 95 percent level, and the results, in general, agree with those in the literature. This research represents a contribution to the anthropology of the north of Chile, but it is not possible to determine ethnic variables considering the small sample in study.

A influência do terceiro molar no apinhamento ântero-inferior / The influence of the third molar on lower anterior crowding

O presente trabalho tem como objetivo avaliar a influência do terceiro molar no apinhamento ântero-inferior bem como indicar a melhor conduta clínica aos Cirurgiões-Dentistas para resolução desse problema. Por meio de revisão de literatura, foram avaliadas a erupção, a impactação, a agenesia e a exodontia profilática dos terceiros molares em relação ao apinhamento dentário. Pôde-se observar a prevalência de três pensamentos distintos a respeito da etiologia: primeiro, a ação dos terceiros molares, por exercerem uma pressão mesial; segundo, acreditou-se que os terceiros molares possuem influência, mas não é a única causa determinante; o último descartou totalmente o relacionamento entre o apinhamento e o terceiro molar. Ademais, de acordo com os autores, a remoção profilática do terceiro molar, a fim de diminuir a força de contato interproximal e solucionar o problema do apinhamento, só foi válida, fossem analisados simultaneamente todos os fatores associados a esse problema. Dessa forma, pode-se afirmar que em pacientes com dentição permanente completa, não foi possível associar o apinhamento ântero-inferior com a presença dos terceiros molares inferiores erupcionados e/ou impactados.

The aim of the present study was to assess the influence of the third molar on lower anterior crowding, as well as to recommend the best clinical management for dental practitioners to solve this problem. The eruption, impaction, agenesis and prophylactic removal of lower crowding were evaluated by means of a review of the literature. It was possible to observe the prevalence of three distinct postures regarding the etiology : first, the action of the third molar in exerting a forward pressure; second, the belief that the third molar has some influence, but is not the only cause; and third, a total rejection of a relationship between crowding and the third molar. Moreover, according to the authors, the prophylactic removal of the third molar to reduce the force of the interproximal contact and to solve the problem of crowding was only valid if all factors associated with this problem were analyzed simultaneously. Therefore, it can be asserted that in patients with complete permanent dentition it was not possible to associate antero-inferior crowding with mandibular erupted and/or impacted third molars.

Endodontic treatment of a fused tooth. Report of a case.

Dental fusion, a rare developmental anomaly present in 0.2% of the general population, consists of the union of two teeth originating from two different tooth germs. The irregular coronal morphology and the complex endodontic anatomy, characterized by the partial or total union of the pulp chambers, together with the peculiarity of the root canal systems, make diagnosis, therapy and rehabilitation difficult. The authors describe the endodontic treatment of a permanent lower second molar fused with a third molar and having four root canals.

¿Es posible predecir la retención de terceros molares inferiores? / Is it possible to predict lower third molars impaction?

La presente revisión trata de una preocupación constante para los odontólogos: determinar la posibilidad de pronosticar la erupción del tercer molar inferior en posición adecuada sobre su conservación o extracción. Las mediciones frecuentemente utilizadas para predecir la erupción del tercer molar inferior se basane n determinar la cantidad de espacio disponible y la dirección que presenta en el momento de su erupción dicha pieza dentaria, las que se recomienda realizar después de los 13 o 14 años, debido a la dificultad de determinar la angulación del tercer molar antes de esa edad (AU)

3er molar mandibular / Mandibular third molar

Una de las inquietudes de los odontólogos, principalmente de los especialistas en ortodoncia y cirugía ora, es saber cuando es necesario extraer los terceros molares o cuando dejarlos para que erupcionen completamente con éxito. Este artículo hace una revisión de los distintos métodos para predecir la impactación o no, del tercer molar mandibular, sobre radiografías panorámicas para que nos permita tomar la decisión correcta (AU)

Light microscopic, cytochemical and ultrastructural studies of a rat odontogenic epithelial cell line.

An odontogenic epithelial cell line, ROE-2B, was established by propagating disaggregated immature, unmineralized maxillary third molar tooth germs from 11-day old Sprague-Dawley rats on a feeder layer of Mitomycin-C treated NIH 3T3 embryonic mouse fibroblasts. The cell line has been maintained for more than 6 months and through 7 passages. Light microscopic examination of cells revealed colonies with epithelial morphology. Electron microscopic examination confirmed the epithelial nature by the demonstration of tonofilaments, desmosomes and basal lamina. Cells were also shown to have secretory vacuoles, an abundance of granular endoplasmic reticulum, free ribosomes, Golgi complex and mitochondria. Surface activity in the form of pseudopodia-like projections and micropinocytosis were noted. Epithelial cells forming keratin were demonstrated by a positive histochemical reaction with Rhodanile Blue. Immunohistochemical studies showed a positive reaction for CAM 5.2 indicating that the ROE-2B cells express the cytokeratins of simple or glandular epithelia. The ROE-2B cell line will be useful for studies on in vitro biological behaviour of odontogenic epithelial cells, and may allow the establishment of in vitro models of odontogenic tumours.

Ultrastructure of a new generation of odontoblasts in grafted coronal tissues of mouse molar tooth germs.

Third molar tooth germs were removed from 14-day-old mice and freed from the enamel organ and follicle. After section of the apical tissues, including Hertwig's sheath, they were transplanted in 1-day-old newborn mice of the same lineage. Electron microscopy of grafts removed 7, 14 and 21 days later showed that, following the disappearance of the initial layer of odontoblasts and a period of adaptation, 14 days after transplantation newly differentiated odontoblasts deposited tubular dentine. The dentine matrix production was increased over that of controls, demonstrating that synthesis was accelerated, possibly because of lack of nerves in the grafts. Numerous characteristic structures that might be involved in the transit of proteoglycans from the Golgi apparatus were seen, as far as the extremity of the odontoblast processes. The particular experimental conditions allowed the observation in the neck region of the odontoblast of a concentration of coated vesicles which might be involved in cellular lengthening. Thus, in the presence of a fine and regular vascular network, a new generation of odontoblasts may differentiate, even in the absence of epithelial and nervous elements, and so predentine may contain inductive factors that allow the odontoblastic differentiation of pulp cells in contact with it.

Calbindin-D28 kappa localization in rat molars during odontogenesis.

Specific antiserum raised against Calbindin-D28 kappa, a vitamin D-dependent calcium-binding protein (CaBP) isolated from chick intestine, was used for localization of the protein in developing rat molars. Previously, CaBP had been localized in specific cells associated with the continuously erupting rat incisor: late pre-secretory ameloblasts, secretory and maturation zone ameloblasts, stratum intermedium cells adjacent to ameloblasts in the late zone of enamel secretion, and papillary cells underlying maturation zone ameloblasts. In this study, the peroxidase anti-peroxidase technique was used for localization of the peroxidase anti-peroxidase technique was used for localization of CaBP in histological sections of rat mandibles from 18-day-old rat embryos through 20-day-old neonates. CaBP was not detected in any cells of the enamel organ, dental papilla, or dental sac during early odontogenesis from the dental lamina stage through the advanced bell stage. The protein first appeared in secretory ameloblasts which were situated opposite odontoblasts with newly secreted dentin. CaBP was present in the cytoplasm of more mature ameloblasts, but not in less mature ameloblasts. Some stratum intermedium cells subjacent to well-developed secretory and maturation zone ameloblasts also contained CaBP. The protein was not detected in odontoblasts, pulp cells, or other cells associated with the developing molars. It was also absent from the demineralized enamel and dentin matrix. In developing rat molars, the time-course of appearance of CaBP, a protein dependent for its synthesis on the vitamin D endocrine system in other organ systems, suggests a potential direct role of this hormonal system in enamel mineralization.