Strategic treatment for a patient with missing lateral incisor and first molar accompanied by posterior scissor bite and an impacted premolar.

Managing orthodontic treatment for adults with missing permanent teeth can be intricate, especially when dealing with a posterior scissor bite and an impacted tooth. This case report presents successful treatment of a female patient with dental and skeletal Class II malocclusion, high mandibular plane angle, missing maxillary left lateral incisor and mandibular right first molar, as well as right posterior scissor bite, and a deeply impacted mandibular left second premolar. In the maxilla, the right second molar and right lateral incisor were strategically extracted to eliminate the scissor bite and enhance frontal esthetic balance. In the mandible, the edentulous space caused by early loss of the first molar was successfully closed and the impacted second premolar was guided into its proper position after surgical exposure. Finally, symmetric frontal esthetics, well-aligned dentition with ideal intercuspation and an improved profile were achieved, which remained stable in the 17 month follow-up.

A Conservative Approach towards Aesthetic, Functional, and Psychological Management of Non-Syndromic Oligodontia Patient: A Case Report with 12-Year Follow-up.

Dental agenesis is the most common developmental aberration in humans, and it is typically linked with a variety of other oral anomalies. Oligodontia, anodontia, and hypodontia are the words used in the literature to denote missing teeth. Although tooth agenesis is not a serious public health problem, it can cause speech, masticatory, aesthetic, and functional problems. A multidisciplinary approach is necessary to establish comprehensive treatment planning, counselling sessions, and frequent follow-ups, to obtain stable, functional, and psychological rehabilitation, which will eventually improves the patient's quality of life. In this case study, after considering the young age and growth of the patient and also his financial status, a conservative approach to rehabilitate the non-syndromic oligodontia patient with a 12-year follow-up and fabrication of maxillary overlay denture and mandibular conventional complete denture has been discussed.

Relationship between craniofacial morphology and congenitally missing mandibular incisors.

Background/purpose: Treatment of incisors' agenesis is challenging that arouses orthodontists' interests. The purpose of this study was to compare the craniofacial pattern of individuals with or without congenitally missing mandibular incisors. Materials and methods: This retrospective study included patients receiving orthodontic consultation between 1999 and 2019 at the Orthodontic Division of the Dental Department of Taipei Medical University Hospital. Cephalometric measurements were obtained through manual tracing and by using computer software. A total of 31 measurements were obtained to evaluate skeletal, dental and soft tissues, and chin morphology. A multivariate analysis of covariance, analysis of covariance, and Scheffé's post hoc tests were used to analyze the differences among a group of patients with one congenitally missing mandibular incisor (M1), a group of patients with two congenitally missing mandibular incisors (M2), and the control group. Student's t-test was used to analyze the differences between the M1 or M2 group and the control group. Significance was set at P < 0.05. Results: Significant differences were observed between the M and control groups in terms of lower incisor angulation and facial balance. Regarding chin morphology, significant differences were noted between the M and control groups and also among the M1, M2, and control groups. Conclusion: The lower incisors of the M group are more retroclined than those of the control group, resulting in retrusive lower lips. Facial balance varies between the M and control groups. Congenitally missing mandibular incisors affect chin morphology, making the chin button prominent.

Association of congenital missing of maxillary lateral incisors with cervical vertebral body fusions and/or atlas posterior arch deficiency.

To evaluate the association between congenital missing of maxillary lateral incisor (MLI) with cervical vertebral body fusions, posterior arch deficiency, and both anomalies. A total of 64 subjects (24 males and 40 females; mean age 16 ± 4.5 years) were detected to have congenital missing of MLI and selected as a study group. Two hundred and fifty-six subjects (87 males and 169 females, mean age 18.1 ± 3.2 years) were assigned to the control group. In the congenital absence of MLI, 53.7% revealed cervical column body fusion, 11.1% indicated a posterior arch deficiency, and 9.3% showed cervical column body fusion with posterior arch deficiency. Morphological deviations of the cervical column showed significant associations with congenital absence of MLI compared to control group (p < 0.001). There were no significant differences in gender among the study and control groups (p > 0.05). Subjects with congenial MLI tend to have an increased frequency of cervical anomaly.

Detection of MSX1 gene mutations in patients with congenital tooth loss in Van der Woude syndrome / 口腔疾病防治

Objective@#To explore the relationship between MSX1 gene detection and tooth loss in a Van der Woude syndrome (VWS) family @* Methods @# DNA was extracted from the venous blood of 2 patients with dental hy⁃podontia in the 9th family of Van der Woude syndrome (VWS) families and 62 controls with complete dentition. Primers were designed for the MSXl gene. The coding regions of exons 1 and 2 of the MSX1 gene were amplified by PCR. The purified products of exons 1 and 2 of the MSX1 gene were sequenced and analyzed by sequence alignment @*Results@#The ivs2+68 C>T polymorphism in the MSX1 gene was found in the VWS9 members with tooth loss, and the VWS pa⁃tients with IRF6 gene mutations had increased tooth loss@* Conclusion@#Congenital tooth loss in the patients with con⁃genital missing teeth in VWS family 9 may be related to the ivs2 + 68 C> T polymorphism of the MSX1 gene.

Effects of Maxillary Lateral Incisor Agenesis on Skeletodental Characteristics in Mixed Dentition / 대한소아치과학회지

This study aimed to evaluate skeletodental characteristics of patient with maxillary lateral incisor agenesis (MLIA) in mixed dentition.It involved the children in early mixed dentition who visited Pusan National University dental hospital for orthodontic purposed and had intact primary canines. 38 children with MLIA and 38 controls with the same chronological age satisfying the inclusion criteria were selected. The craniofacial structures and dental arch dimensions of the MLIA were evaluated using model & cephalometric analysis and compared to controls.The rate of unilateral MLIA was high in male and the rate of bilateral MLIA was high in female. In model analysis, the width / length ratio of maxillary anterior portion of the MLIA group were higher and arch perimeter of the maxilla of the MLIA group were smaller than those of the control group (p = 0.003, 0.04). Cephalometric analysis showed that there were no significant differences in terms of skeletal, dental analysis. In soft tissue profile, nasolabial angle was larger in MLIAs than in controls (p = 0.039).Considering these skeletodental characteristics of MLIA, early diagnosis and proper management is highly recommended to minimize the possibility of functional defect.

Effect of Developmental Disorders of Maxillary First Molars on Orofacial Morphology / 대한소아치과학회지

This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars.Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian' s method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated.Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency.Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.

Dental treatment considerations for a pediatric patient with incontinentia pigmenti (Bloch-Sulzberger syndrome).

Incontinentia pigmenti (IP) is a uncommon gene disorder, heritage with X-linked dominant mode. IP patients have a characteristic dentition varying from marked hypodontia to delayed eruption and conical crowns on both dentitions. A 5½-year-old girl, whose mother and younger sister were also diagnosed with IP, has the whirling-like pigmented skin lesion over her trunk and four extremities. Four primary teeth and multiple permanent tooth germs were found to be congenital missing. Dental considerations of further treatment were discussed with her parents including the preservation of primary molars, possible interim prosthesis in mixed or permanent dentition, full mouth rehabilitation with orthodontic and prosthodontic combined treatment, and implant therapy in adulthood. Early and longitudinal involvement of pediatric dentist to deal with the dental complications of IP can not only solve the esthetic problem and oral function but also maintain the oral health of children with IP to adulthood.

Systematic review and meta-analysis of congenitally missing permanent dentition: Sex dimorphism, occurrence patterns, associated factors and biasing factors.

PURPOSE: We aimed to summarize/analyze, comprehensively and for the first time, the literature on the prevalence of congenitally missing teeth (CMT) in males and females and the CMT pattern, taking various associated and biasing factors into account. METHODS: A search was performed independently by two authors during September 2012 till June 2013 to find all the available literature regarding CMT-associated factors and patterns comprising sex dimorphism, arches, anterior/posterior regions, unilateral/bilateral patterns, and involved teeth. The data were statistically analyzed. RESULTS: Seventy-four studies were included. The mean CMT prevalence was 6.42±2.76% in males and 7.55±2.67% in females. Overall, CMT is more prevalent in females but only in epidemiological samples, and not in orthodontic or dental patients. Enrolling orthodontic/dental patients might increase the observed CMT in boys and/or reduce it in girls. Gender dimorphism was not affected by any of the factors: time, regions, or the biasing factors. There is not a significant predominance of maxillary or mandibular involvement, although the anterior segment is more likely to be affected. CONCLUSIONS: CMT is more common in girls and in the anterior segment, regardless of the date of publication. Contrary to the commonly held belief regarding more CMT prevalence in female orthodontic patients, it was shown that in dental/orthodontic patients, CMT prevalence is higher in boys.

Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report / 대한치과보철학회지

In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly.

Prevalence and pattern of hypodontia in the permanent dentition of 3374 Iranian orthodontic patients.

BACKGROUND: Hypodontia is the most common dental anomaly and might cause clinical complications. The aim of this study was to assess the prevalence and pattern of congenital missing in the permanent dentition dentition (excluding third molars), among Iranian orthodontic patients. MATERIALS AND METHODS: In this descriptive cross-sectional study, all approved panoramic radiographs of 3374 orthodontic patients (aged 10 to 20 years old), who had visited the Orthodontic Departments of all Tehran Dentistry Universities and 10 private clinics during the years 1999 to 2009 were investigated, to establish the prevalence of hypodontia in the permanent dentition (excluding third molars). The data were analyzed using a chi-square test (α = 0.01). RESULTS: Included were 2012 female and 1362 male patients. The prevalence of hypodontia was 5.21% (5.86% in females, 4.25% in males). The difference between the genders in terms of missing teeth was not significant (P = 0.202). A total of 298 teeth were missing (166 in females, 132 in males). The average of missing per individual was found to be 1.69 (1.40 missing for each girl, 2.32 for each boy). There was no significant difference between the number of missing teeth in males and females (P = 0.160). The most common missing teeth were maxillary lateral incisors (37.2%), mandibular second premolars (22.1%), and mandibular central incisors (10.7%). In both unilateral and bilateral hypodontia cases, the maxillary lateral had the highest prevalence of missing, followed by the mandibular second premolar. Missing was significantly more frequent (P = 0.001) in the maxilla (5.3%) compared to the mandible (3.5%). CONCLUSION: Out of every 20 Iranian orthodontic patients, one might have some missing permanent teeth, needing early attention. Hypodontia was more prevalent in females (though not significantly) and in the maxilla. Although more females were affected, the number of missing per individual was greater in males.

Prevalence of congenitally missing permanent teeth in Iran.

BACKGROUND: Hypodontia or congenitally missing teeth is among dental anomalies with different prevalence in each region. The aim of this study was to evaluate the prevalence of congenitally missing permanent teeth in Iranian population. MATERIALS AND METHODS: A descriptive, retrospective and cross-sectional study was done. Panoramic radiographs of 2422 Iranian patients (1539 girls and 883 boys), 7-25 years old, were collected. The radiographs were studied for evidence of congenitally missing teeth. Data were analyzed using Paired t-test, Mann-Whitney test, Fisher exact test and Chi-square test (α = 0.05). RESULTS: Prevalence of congenitally missing teeth was totally 45.7% and 34.8% for third molars. The most frequent congenitally missing teeth was mandibular second premolars (23.34%) followed by maxillary second premolars (22.02%). Upper jaw showed significantly higher number of congenitally missing teeth (P value < 0.001). According to Chi-square test, congenital missing teeth was found approximately 10.9% in both females and males and there were no statistically significant difference between sexes (P = 0.19). CONCLUSION: The prevalence of congenitally missing teeth (CMT) in Iranian permanent dentition was 10.9%. The most common congenitally missing teeth were mandibular second premolar fallowed by maxillary second premolars.

Pre-eruptive coronal resorption and congenitally missing teeth in a patient with amelogenesis imperfecta: a case report.

This clinical report describes a male with autosomal recessive generalized hypoplastic amelogenesis imperfecta. This case is unusual in coronal resorptions prior to tooth eruption. This finding has been reported in some cases of autosomal recessive, autosomal dominant and X linked amelogenesis imperfecta (AI). In reported cases, the defects were usually small and occurred in a maximum of 2 teeth per person. In our case, pre-eruptive coronal resorptions affected three second molar teeth from both jaws. On the other hand; congenitally missing teeth and malocclusion were present in this case. Recall evaluations at 3 month intervals occurred for a period of 2 years and then prosthodontic management began.

Clinical study on the anomalies of number and morphology in cleft lip and palate patients' teeth / 대한치과교정학회지

Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies and occurs more frequently in Asian people. Dental abnormalities in number, size, shape, and eruption of teeth are frequently associated with CLP. The purposes of this study were to investigate the effects of CLP on number, size, shape and eruption of teeth and to provide basic clinical data for diagnosis and treatment of the CLP patients. With the orthodontic and cleft charts, diagnostic models, orthopantomograms and intraoral x-ray films from 241 CLP patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital, we evaluated the frequency of congenital missing teeth, supernumerary teeth, impacted teeth, and microdontia. The results were as follows ; 1. Frequency of congenital missing was relatively high up to 56.8 %. Congenital missing occurred frequently in the maxillary lateral incisor and the maxillary second premolar. Among the CLP types, frequencies of congenital missing in cleft lip and palate group and cleft lip and alveolus group were higher than those of cleft lip group and cleft palate group. And bilateral cleft showed higher frequencies than unilateral ones. 2. Supernumerary tooth was shown in 11.2 % of CLP patients. It occurred frequently in the area between the maxillary lateral incisors and the maxillary canine. Among the CLP types, cleft lip group showed relatively most highest frequency. 3. Impaction was shown in 18.3 % of CLP patients. It occurred most frequently in the maxillary lateral incisor and the maxillary canine than other teeth. Among the CLP types, cleft lip group and cleft lip and palate group showed most highest frequencies. 4. Microdontia was shown in 15.8 % of CLP patients. It occurred the most frequently in the maxillary lateral incisors and maxillary canines. Among the CLP types, cleft lip and alveolus group and cleft lip and palate group showed relatively higher frequencies. There was no microdontia in cleft palate group.

A study of the frequency of congenital missing and supernumerary teeth in cleft lip and palate patients / 대한치과교정학회지

The purpose of this study was to evaluate the frequency of congenital missing teeth and supernumerary teeth in cleft patients. The subjects were divided into bilateral cleft lip and palate(BCLP), unilateral cleft lip and palate(UCLP) and cleft palate alone(CP alone) groups. 97 cleft patients(BCLP 15, UCLP 70, CP alone 12) between 6-20 years old were evaluated. Panorama film, Orthodontic chart and initial intraoral photogram were employed for this research. The obtained results were as follows. 1. The incidence of congenital missing teeth in total cleft samples was 57.7 %, and the incidence of supernumerary teeth was 26.8 %. Each incidence was higher than non-cleft. 2. The incidence of congenital missing teeth was the highest in BCLP and the lowest in CP alone. 3. The number of congenital missing teeth per perso was usually one, and the frequency was higher in the maxilary lateral incisors(67.8 %), and maxillary second premolar(14.9 %) than other teeth. 4. Most of tooth number anomalies in cleft patients were found in maxilla, especially adjacent region to the cleft site.