Purpose: The low frequency of concomitant hypo-hyperdontia and the lack of established clinical protocols in treatment are our motives to analyse our experience in three different clinical cases and derive principles of clinical behaviour. Material and methods: Analysis of the documentation of the 2886 patients, from which three clinical cases were with CHH: case 1 – agenesis of the second upper primary molars and hyperdontia of the upper left lateral; case 2 – Hyperdontia of the upper primary and permanent left lateral and hypodontia of the lower left second premolar; case 3 - two supernumerary (left and right) canines and hypodontia of the lower right second premolar. Results: From all the patients diagnosed and treated by us, hypodontia was found in 7.38% (excluding third molar hypodontia); hyperdontia in 1.9% and only 0.1% have concomitant hypo-hyperdontia. In the three patients, hyperdontia occurs in the frontal segment, and the phenomenon of hypodontia covers the distal segments. Discussion: Following the treatment plans of all three clinical cases, the following stereotype is required as a treatment approach: Solving the problem of hyperdontia (extraction); Levelling dental arches; Solving the problem of hypodontia - placement of implants or closing the space; Retention. In practice, it is found that the solution starts with a relatively smaller problem - hyperdontia, especially in cases where we have access to these teeth. The more serious obstacle is hypodontia, which, if unilateral, leads to disruption of the occlusal ratios. Conclusion: CHH is a rare problem, and the treatment is long, and its favourable outcome depends on early diagnosis.
In the process of odontogenesis, a disturbance in the formation of the epithelium and mesenchyme can be observed and this can be manifested by atypical forms of dental development. Such biological phenomena with altered morphology are as follows: dens invaginatus (DI), dens evaginatus (DE), talon cusps, and double teeth (DT) or connate teeth (fusion and gemination). Patients with orthodontic anomalies who also exhibit teeth with morphogenetic disorders are presented in this article. Dens evaginatus and talon cusps pose orthodontic challenges in the treatment finishing phase. These reduce the possibility of achieving maximum intercuspidation between the lower and upper front teeth as well as poor incisor guidance. Other orthodontic challenges are as follows: the risk of occlusal trauma and periodontal loading of the antagonists and the possibility of accessory cusps to play the role of the inclined plane and lead to deviations in the closure of the lower jaw. The fused teeth can cause aesthetic and occlusal disturbances in the anterior segment. Furthermore, double teeth can lead to ectopic eruption or noneruption of adjacent teeth due to their increased crown size as is the case with one of the presented patients. This is because a double tooth occupies more space in the dental arch. If not diagnosed early, impaction of the adjacent tooth, violation of the occlusal ratios (Bolton/anterior), and exacerbation of the orthodontic deformity can be observed. The modern CBCT imaging is the best diagnostic method for identifying problems related to tooth positions or tooth germs.
Introduction: Hypodontia and hyperdontia are two dental phenomena with deviations in the number of teeth - reduction and increase of tooth germs. The aim of the study is to compare the frequency of manifestation of hyperdontia and hypodontia, their distribution by tooth groups among Bulgarian orthodontic patients. Materials and methods: The prospective clinical-epidemiological study covered 2676 patients: 1705 (63.7%) female and 971 (36.3%) male. They were detected and diagnostically proven with supernumerary and missing teeth. The findings were distributed according to their localization to make a comparative analysis. Results: The patients established with hypodontia were 5.79% with average age of 15.17±5.34 years, and hyperdontia in 3.13% of patients with average age of 11.80±4.65 years. Statistically credible, hyperdontia was more frequently observed in males, while hypodontia was significantly more frequently observed in females. The hypodontia was the most commonly observed in the mandibular distal segment - second premolars (46.5%), next affected was the maxillary lateral (37.4%), followed by the maxillary distal segment (32.3%), and the least was the mandibular frontal segment (12.9%). The supernumerary teeth found in the maxillary frontal segment were incisors and mesiodens (91%) compared to the maxillary distal segment (9%) was significant. In the mandible, the difference between the frontal (42.3%) and distal segment (57.7%) was without statistical significance. Conclusions: Knowledge of the clinical characteristics of hypodontia and hyperdontia are important for targeted early diagnosis and treatment. Both of these specific problems have an effect on an individual's function and psychosocial well-being.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.