Monday, January 24, 2011

Taurodontism in Children w/ Hypodontia and Supernumerary Teeth: A Case Control Study


Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Taurodontism in Children w/ Hypodontia and Supernumerary Teeth: A Case Control Study
Author(s): Wayne Kan, BDsc, DClinDent, et al
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2009. V 32 NO 2. 134-140

Major topic: Taurodontism (TD)
Overview of method of research: 120 cases of children w/ TD were selected from a dental schools patient base. 83 of the children had hypodontia, and 37 children had supernumerary teeth. The crown-body root ratios of the permanent first molars of these children were compared with the same teeth in ‘normal’ case controls. The teeth were examined using the Seow and Lai technique. The teeth were outlined on an OPG and were traced by a single examiner.

Findings:
TD was first used to describe a characteristic molar trait seen in Neanderthal fossils. The definition of TD molars is teeth that have a tendency for the body of the tooth to enlarge at the expense of the roots. TD can be found in both primary and permanent teeth. TD can exist as either as an isolated trait or as a feature of multiple system malformation syndromes such as ectodermal dysplasia, Klinefelter syndrome, Down syndrome, trichodento-osseous dyplasia, and x-linked hypophosphatemic rickets, amelogenesis imperfecta and hypodontia. The etiology of TD is still unknown, however it has been proposed that it’s a result of disrupted developmental homeostasis, and involves a delayed invagination of Hertwig’s epithelial root sheath.

Key points/Summary:
In children with hypodontia, only the girls showed a significantly higher tendency for TD compared to the controls. This is likely to be a genetic issue, and possibly related to the x-chromosome. Boys with hypodontia showed a similar prevalence of TD to normal teeth. Children who had multiple missing teeth were significantly more likely to have TD than children who had one tooth missing. Conversely, TD in children with SN teeth was similar to the control group. Teeth with TD showed a higher prevalence of root resorption during ortho treatment, although this observation has not been confirmed. TD teeth also pose issue for endodontic and prosthodontic therapy (never place a post in a tooth with TD). More studies are needed on all of these subjects

Assessment of Article: Simple, basic knowledge article. Good information. Only one examiner makes the results standardized, but it also only gives us one persons view concerning the teeth. Most importantly, things to take away from this article for boards are
1. TD is associated with nonsyndromic hypodontia in girls, but not with nonsyndromic children with SN teeth
2. Children with multiple missing teeth are more prone to TD than a child who is only missing one tooth

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