Prevalence of Teeth Number Anomalies in Permanent Dentition in a Sample From Erbil City (an Orthopantomographic Study)

Khoshee Salih Al-Mufty, Rebin Ali Mohammed Amin, Fedil Andraws Yalda Ahmad Abdullah Haidar
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Keywords : Hypodontia, Supernumerary, Prevalence, Orthopantomograph
Medical Journal of Babylon  14:1 , 2017 doi:1812-156X-14-1
Published :18 July 2017

Abstract

Supernumerary teeth are those teeth developed along with normal complement as a result of excess dental lamina in the jaws. Developmentally missing teeth include hypodontia, oligodontia and anodontia. Congenital missing of one or more teeth or a supernumerary tooth requires an urgent treatment as suggested by the Index of Orthodontic Treatment Need. This study tries to evaluate the prevalence and distribution of tooth number anomalies in Erbil patients in relation to the side, jaw, tooth types, and gender. Three thousand orthopantomograms of patients (9-36) years old who is seeking dental treatments are used to determine the spreading and distribution of the hypodontia, oligodontia, and hyperdontia. Their radiographs are retrieved from Orthodontics and Radiographic Clinics at the College of Dentistry, Hawler Medical University, Erbil/Kurdistan Region of Iraq and private dental radiographic clinic in period from 2013 till 2015. A tooth is diagnosed as congenitally missing in case of no identification or discerned radiographically on the basis of calcification or there is no removal evidence. The chi- square test is to determine the importance of the upper and lower numerical teeth abnormality differences and the differences between genders. Five percent was set as the level of significance. Hypodontia was prevalent by 7.76%, it was more often found in females in right side of maxilla. The most missed tooth was maxillary lateral incisor. The permanent congenital missing teeth were frequently in the maxilla. Mesiodens was the most common supernumerary tooth, and its prevalence was 1.13%.

Introduction

Dental anomalies include any abnormality in the size, form, position and number of teeth numbers [1]. Supernumerary teeth are teeth formed extra to normal complement as a result of excess dental lamina in the jaws [2]. Developmentally missing teeth include hypodontia when one of the six teeth is absent, oligodontia when more than six teeth are absent, and anodontia when all teeth are absent [3]. Congenital missing or supernumerary teeth result in greater need of treatment as suggested by the Index of Orthodontic Treatment Need [4]. Therefore, hypodontia prevalence and hyperdontia informations are very important for early diagnosis and proper treatment planning [5,6]. It is important to prevent hypodontia complications like malocclusion ,diseases of periodontia, and negative effects on growing alveolar [7-9]. Prevalence regularity differences expected regarding to the variety in samples concerning measuring techniques, radiography different methods and clinical examinations, age, gender, geographic or demographic profiles [8,10, 11,12]. Clinically, supernumerary teeth may bring different local disorders, such as primary tooth retention, delayed eruption of the permanent tooth, ectopic eruptions, tooth displacements, follicular cysts, and other alterations, requiring surgical or orthodontic intervention [13,14]. Supernumerary teeth are known by the region where they locate. Mesiodens is usually placed between both central upper incisors [15]. This paper is study the evaluation of the prevalence and distribution of tooth number anomalies in Erbil patients in relation to the side, jaw, tooth types, and gender.

Materials and methods

In this study, three thousand orthopanto-mograms of patients who are seeking dental treatment are used to determine the diffusion and distribution of the hypodontia, oligodontia, and hyperdontia. Their radio-graphs are retrieved from Orthodontics and Radiographic Clinics at the College of Dentistry, Hawler Medical University, Erbil/Kurdistan Region of Iraq and private dental radiographic clinic in period from 2013 till 2015. Patients between the ages of 9 to 36 when the OPGs were taken without history of removed teeth are included in the study. Patients who have any sort of systemic anomaly, particularly cleft lip/ palate and Down’s syndrome were excluded from the study because of delayed tooth development in such conditions [8].
    A tooth is diagnosed as congenitally missing in case of no identification or discerned radio graphically on the basis of calcification or there is no removal evidence. If the hypodontia diagnosis is not accurate, the file was excluded. Radiologist and orthodontist was investigated the hypodontia prevalence of permanent dentition (excluding missing third molars) and its occurrence pattern concerned the involved sides (left vs. right / anterior vs. posterior), tooth types, and gender twice.
   Statistical analysis: The chi- square test is to determine the importance of the upper and lower numerical teeth abnormality differences and the differences between genders. Five percent was set as the level of significance.




Results

For investigation of hypodontia, this study reviewed and examined of a total three thousand patients, in which 1469 were males (48.97%) and 1531 were females (51.03%). Hypodontia teeth were noticed in 233 patients (139 females and 94 males) and the hypodontia prevalence was 6.39% in male and 9.07% in female, and for both together was 7.76% (Table 1). A total of 497 permanent teeth were missing (197 in males and 300 in females). Of all cases, one to five teeth hypodontia had a prevalence of 7.76 % and represented 97.07%. hypodontia of one tooth were found in patients by 37.91% while 40% had hypodontia of two teeth and 9.16% were missing three teeth and just 8.75% were missing four teeth.

Discussions

The prevalence of hypodontia is between 4% and 11.3% [1-14], however in this study, it was found to be 7.78% which is more than the percentage of studies done in Portugal [1], Iran [15], Venezuela [16], Turkey [17] and Egypt [18], but less than Japan [19] and Korea [20]. Frequently, hypodontia was more noticed in females which was a statistically different significantly. This result is in agreement with results of some other studies [6, 8,13,14]. Higher prevalence also noticed in females rather than males in several reports [16,19,21] apart from a small group of 217 patients of orthodontic [22]. More frequently, congenitally permanent teeth were missing in the maxilla than in the mandible. This come in accordance to the results in Helton et al. [4] and in contrast to the several other researches [23, 24 25].

Conclusions

The study showed that about 9.13% of patients had anomalies of teeth number. Hypodontia happens more often than hyperdonti. Hypodontia was more frequently found in females with significant difference. The most frequently missing tooth was maxillary lateral incisor which is followed by the mandibular second premolars. About hyperdontia, the difference between maxilla and mandible, right and left side for male and female was non-significant. The most frequently found supernumerary tooth was Mesiodens.

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