Numeric anomalies of teeth in concomitant hypodontia and hyperdontia

Variations in tooth number in children, each of whom had supernumerary teeth and agenesis of teeth, is described. Among the 11, seven had cleft lip and palate, and two had clefting syndromes; two children had dental anomalies only. Only children who had both supernumerary teeth and congenitally missing teeth outside the area of the cleft alveolus were included. Concomitant hypodontia and hyperdontia were observed in the same dentition in nine subjects, in the same jaw in eight subjects, and in the same jaw quadrant in only three subjects. Supernumerary teeth and agenesis of teeth were observed simultaneously more often in the permanent dentitions than in the deciduous dentitions or in both dentitions simultaneously. The overall number of supernumeraries was 10 in the deciduous dentition and 14 in the permanent dentition of the 11 subjects. The number of congenitally absent teeth was 14 in the deciduous dentition and 40 in the permanent dentition. The etiology of concomitant hypodontia and hyperdontia is difficult to explain. It may result from disturbances in migration, proliferation, and differentiation of neural crest cells or interactions between the epithelial and mesenchymal cells during the initiation of odontogenesis.     

Dental anomalies and dental variations in the red foxVulpes vulpes in the Czech Republic

Dental abnormalities including polydonty, oligodonty, extra roots, different root morphotype, root fusion, different crown morphotype, crown reduction, partial crown eruption, supernumerary cusp, irregularities in the position of the teeth, and malocclusion were studied in a set of 785 red foxVulpes vulpes (Linnaeus, 1758) skulls (401 males, 273 females, and 111 individuals of unknown sex) from the Czech Republic. Three hundred sixty one cases of deviations from normal were found in 170 specimens (21.7%). Most of the deviations were variants within a genetically determined range. The prevalent dental variants included an extra root of M¹ (5.7% specimens), and different root morphotype of P₁ (1.9% specimens). On the other hand, the real dental anomalies, eg polydonty, occurred seldom within the population. P₁ ¹ and M₃ were missing significantly more frequently among females than among males unlike the other deviations, which were divided equally between the sexes. No differences were found between the left and right side of the jaw. Irregularities in the position of the teeth and oligodonty (excluding P¹ ₁, M₃) appeared significantly more abundantly on mandible, whereas extra roots and polydonty were more common on the maxilla. There was no relationship between the incidence of dental abnormalities and the relative mandible and rostrum length.     

Some observations on the dentition of an isolated group in northeast Poland.

Clinical examination of the teeth and the mouth was carried out on a group of 133 "Old Believers," 54 males and 79 females, and a control group of 138 Poles living in the same area of Augostova in northeast Poland, 63 males and 75 females. Studying the frequency of Carabelli's cusp, shovel-shaped incisors, missing teeth, microdonita, supernumerary teeth, and torus palatinus in both groups, it was found that Carabelli's cusp and torus palatinus are more frequent among Poles. Such differences could be attributed to differences in ethnic origin of the two groups.     

Dental anomalies within extant members of the mammalian Order Pilosa

Recent discovery of a supernumerary dental anomaly in two‐toed sloths led to an extensive review of extant sloth specimens to look for additional anomalies. In total, 881 museum specimens were examined. These revealed two primary types of anomalies, hyperdontia (extra teeth) and anodontia (loss of teeth), occurring at a rate of 2.4% (n = 21). Two‐toed sloths, Choloepus, were more likely to have hyperdontia in the anterior dentition, whereas three‐toed sloths, Bradypus, experienced anodontia more frequently with the upper caniniforms. Both genera experienced both anomalies. The majority affected the upper dentition, with only three specimens exhibiting mandibular anomalies. Beyond the patterns of tooth positioning, all anomalies were random with respect to age, sex and geography. A few specimens not counted in the initial assessment expressed incomplete anodontia, indicating that the loss occurred postnatally and was not an embryological anomaly. For Bradypus, the findings provide new support for the hypothesis that the taxon represents a neotenic lineage and opens new possibilities about its relationship to the extinct ground sloths with a suggested rooting above that of the basal position it typically occupies for Folivora.     

Peri-gestational risk factors for pediatric brain tumors in Neurofibromatosis Type 1

BackgroundIndividuals with Neurofibromatosis Type 1 (NF1) are strongly predisposed to developing pediatric brain tumors (PBTs), especially optic pathway gliomas (OPGs). Although developmental factors have been implicated in the origins of PBTs in both human and animal studies, associations between early-life factors and PBTs have not been evaluated in individuals with NF1. Our objective was to evaluate associations between peri-gestational characteristics and PBTs in this population.MethodsWe conducted a cross-sectional study, ascertaining questionnaire and medical record data for 606 individuals <18 years old who enrolled in the NF1 Patient Registry Initiative (NPRI) from 6/9/2011-6/29/2015. One hundred eighty-four individuals had reported PBT diagnoses, including 65 who were identified with OPG diagnoses. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PBT and OPG diagnoses and peri-gestational characteristics (prematurity, birth weight, parental age, plurality, family history of NF1, assisted reproductive technology, maternal vitamin supplementation, and parental smoking).ResultsWe observed no significant associations between any of the assessed characteristics and PBTs overall or OPGs with the exception of birth weight. After controlling for potential confounding variables, we observed a significant positive association between birth weight quartile and OPGs with a HR of 3.32 (95% CI 1.39⿿7.94) for the fourth (⿥3915.5 g) compared to the first (⿤3020 g) quartile (p for trend = 0.001).ConclusionsConsistent with results for PBTs in the general population, these results suggest that higher birth weights increase OPG risk in individuals with NF1.     

Hypodontia: Prevalence and pattern amongst the living Druze population – A Near Eastern genetic isolate

The Druze population is a small-sized Near Eastern genetic isolate with high rates of consanguineous marriages. The present study aimed at investigating prevalence, pattern and distribution of hypodontia in the permanent dentition, excluding wisdom teeth, amongst this population. Panoramic radiographs, dental casts, and anamnestic records of 85 un-admixed Druze schoolchildren (45 males, 40 females; age range = 14–18 years, mean age = 16 years, SD = 0.5 years) were examined for evidence of hypodontia. Those with any type of facial clefts or craniofacial syndromes were excluded. Hypodontia prevalence was 11.8% (11.1% for males, 12.5% for females) with no statistically significant difference between sexes. The average number of missing teeth per child was 1.4 (1.2 for males, 1.6 for females). The majority (90%) of affected individuals exhibited minor hypodontia (one or two teeth missing). The most commonly missing teeth were upper lateral incisors and canines, followed by lower and upper second premolars. Asymmetrical hypodontia was more prevalent. Maxillary, left side, and anterior segment predominance were observed. The distinct features of hypodontia among the Druze population are the relatively high prevalence of minor hypodontia, and the upper lateral incisors and canines being the most commonly missing teeth.     

The activation level of the TNF family receptor, Edar, determines cusp number and tooth number during tooth development

Mutations in members of the ectodysplasin (TNF-related) signalling pathway, EDA, EDAR, and EDARADD in mice and humans produce an ectodermal dysplasia phenotype that includes missing teeth and smaller teeth with reduced cusps. Using the keratin 14 promoter to target expression of an activated form of Edar in transgenic mice, we show that expression of this transgene is able to rescue the tooth phenotype in Tabby (Eda) and Sleek (Edar) mutant mice. High levels of expression of the transgene in wild-type mice result in molar teeth with extra cusps, and in some cases supernumerary teeth, the opposite of the mutant phenotype. The level of activation of Edar thus determines cusp number and tooth number during tooth development.     

Population analysis of dental anomalies of ottersLutra lutra from eastern Germany

A sample of 1037 skulls of ottersLutra lutra (Linnaeus, 1758) from eastern Germany was analysed for inherent dental abnormalities. Deviations from the normal dental pattern were found in 107 individuals. A total of 150 cases were classified in 5 categories of abnormality. In considering variations from the normal number of teeth, supernumerary (polydonty, 1.7%) was more frequent than missing teeth (oligodonty, 0.9%). In most cases, numerical variations were not connected with phylogenetic background. The most frequent variations were displacement of teeth in the tooth row (6.0%) and deviations of the normal shape of teeth (3.3%). Variations of the local position of teeth occurred in 2.6% of cases. None of these deviations showed significant sex-dependent differences. Furthermore, no regional differences in the frequencies of these anomalies were noticed. Another 459 otters (822 cases) had accessory roots at P2, P3, or P4. These characters were considered as non-metrical traits and used to study epigenetic regional differentiation. The Mean Measure of Divergence segregated the Baltic coast from almost all other regions. Preliminary results of analysis of Fluctuating Asymmetry are presented, using these traits to demonstrate the utility of dental deviations for estimating influences on developmental stability. Generally, it can be stated that the dentition of otters is very stable.     

A pilot study on the prevalence of maternal obesity in selected Greek counties

ObjectiveTo report a pilot prevalence of maternal overweight, obesity and underweight in selected Greek counties.MethodsA total of 441 adult childbearing women were recruited from maternity clinics in 6 Greek counties for this cross-sectional study. Pre-gravid weight status was defined according to the WHO cut-offs and gravid weight status was diagnosed with the Mardones and Rosso weight gain chart.ResultsDuring gestation the majority of the participants were of normal body weight (BW) (34.0%), obesity was apparent in 25.6% of the sample, 23.8% of the participants were underweight, and the remaining 16.6% were overweight. Overall, pregnancy tripled the prevalence of underweight, increased the prevalence of obesity (by 388.0%) and decreased the number of participants in the normal BW category (p ≤ 0.001 for all). The majority of participants classified in each pre-gravid weight-category remained in the same weight category during their gestation. All the pre-gravidly obese women were also obese during pregnancy. Underweight was more prevalent in Kavala (37.5%) and obesity was more frequent in Thessaloniki (30.8%). Women who were overweight prior to conception were highly likely to be overweight/obese during pregnancy (OR: 23.8, CI: 11.1–51.0).ConclusionsThe results indicate a high prevalence of overweight, obesity and underweight among pregnant women in Greece.     

Dental anomaly in a fossil squalodont dolphin from New Zealand,and the evolution of polydonty in whales

Abstract

A fragment of mandible of an indeterminate squalodontid dolphin (Upper Oligocene or lowermost Miocene, New Zealand) has 2 anomalous single-rooted teeth intercalated between typically squalodontid anterior cheek-teeth. The anomalous teeth are considered to be truly supernumerary, and not homologous with any erupted teeth in phylogenetically earlier Cetacea. This type of anomaly appears not to have been reported previously for any fossil cetacean. Polydonty, a characteristic of extant odontocetes, was probably attained initially in primitive odontocetes by intercalation of permanent and deciduous teeth, and later was elaborated by the addition of supernumerary teeth. The present specimen represents a morphological (but not phylogenetic) stage between odontocetes with limited and advanced polydonty. Some fossil mysticetes and embryonic extant mysticetes are also polydont, but mysticete polydonty and that of odontocetes have probably evolved convergently.     

The role of lead and cadmium in deciduous teeth and saliva on dental caries in children residing in Tehran,Iran

BackgroundLead (Pb) and Cadmium (Cd) are important environmental contaminants. There is no biological monitoring of exposure to these heavy metals and their potential effect on dental caries in children in Tehran, Iran, a polluted megacity. Therefore, the present study investigated the potential association between Pb and Cd levels in primary teeth and saliva and dental caries.MethodsIn a cross-sectional design, 211 children aged 6–11 years referred to Tehran University of Medical Sciences, School of Dentistry and residing in Tehran were examined. Pb and Cd levels of exfoliated primary teeth and stimulated saliva were determined by atomic absorption spectrophotometry (AAS). Dental caries prevalence was evaluated according to WHO criteria. Socioeconomic status, oral hygiene behavior, snacking frequency and salivary pH data were acquired as confounding factors. Frequency and percentages were reported for categorical variables, mean and standard deviation (SD) for continuous variables, and geometric mean for skewed continuous variables. A simple linear regression and Pearson correlation tests were used for statistical analyses. P-values < 0.05 were considered as significant.ResultThe mean (95 % confidence interval) Pb and Cd levels in teeth were 213.26 ppb (164.29–274.84) and 23.75 ppb (20.86–27.05), respectively. The mean Pb and Cd levels in saliva were 11.83 ppb (10.71–13.06) and 3.18 ppb (2.69–3.75), respectively. Furthermore, Pb and Cd in primary teeth and saliva were not associated (p > 0.05) with socioeconomic status, oral hygiene behavior and snacking frequencyConclusionThis study showed no association between Pb and Cd concentrations in primary teeth and in saliva with dental caries prevalence.     

Oral microflora in betel-chewing adults of the Karen tribe in Thailand

ObjectiveTo study a possible influence of betel chewing on the composition of the oral microflora in plaque and saliva and on oral health parameters as well as a possible betel effect on oral bacteria in vitro.Material and methodsThirty-two adults (16 betel chewers and 16 non-betel-chewing controls) of the Karen Hill tribe in Thailand were investigated. Saliva samples and 2 pooled supragingival plaque samples were taken from each individual for microbial analysis with culture and 4 subgingival samples for analysis with the DNA–DNA hybridization method against 12 periodontitis associated bacterial species. Caries (DMFS), plaque (PlI%) and bleeding on probing (% BoP) was registered as well as number of sites with >5 mm probing pocket depth (PPD). Water extract of the betel (areca chatechu) nut was tested for its antimicrobial effect in vitro against 10 oral bacterial species with the agar diffusion method.ResultsAn antimicrobial effect of betel nut water extract was found on the oral microorganisms in vitro. The levels of mutans streptococci and lactobacilli in saliva were low or absent in both chewers and controls. The prevalence of the periodontitis associated bacteria was >90%. Betel chewers had significantly lower levels of some bacteria in subgingival plaque (Prevotella intermedia p < 0.001) than non-chewers. This study population was low in missing teeth (mean 0.7 and 0.3), caries decay (DS 2.1 vs 1.6), and number of deep pockets (mean 1.9 vs 1.3). Great variation in oral hygiene (PlI and BoP) between the subjects was seen.ConclusionsAn antimicrobial effect of the betel nut was found in vitro and with a possible effect also in vivo however it did not seem to influence clinical parameters such as plaque index, caries prevalence (DMFS), bleeding on probing and number of deep pockets.     

Psychological and clinical characteristics of female patients with spontaneous coronary artery dissection

Aims

Spontaneous coronary artery dissection (SCAD) is increasingly recognised as a cause of myocardial infarction, but psychological characteristics of patients with SCAD have not yet been extensively investigated. We assessed the prevalence of a broad range of psychological and clinical factors, and their inter-relationships in patients with a history of SCAD. Furthermore, we investigated whether specific clusters of patients with SCAD can be identified.

Methods

Participants were recruited between March and May 2019 from a Dutch SCAD database and completed online questionnaires. Clinical information was verified by review of medical records. Participants were predominantly female (172/183; 94%). Analyses focused on the 172 female patients (mean age 52.0 ± 7.5 years, 37% postmenopausal).

Results

The most common comorbidities of SCAD were migraine (52%), fibromuscular dysplasia (FMD; 29%), chronic pain (29%), and tinnitus (28%). Six women (3%) had pregnancy-associated SCAD. Traditional cardiovascular risk factors were rare (<10%), except for hypertension (31%). Psychological assessment indicated high levels of perceived stress (PSS-10 ≥14; 50%), fatigue (FAS-10 ≥22; 56%), and a frequent history of burnout (25%). The prevalence of depression (9%) and anxiety (12%) was relatively low. Three clusters were identified: (A) FMD and chronic non-ischaemic conditions (tinnitus, chronic pain, and irritable bowel syndrome); (B) migraine; and (C) none of these conditions.

Conclusion

This study shows that perceived stress and fatigue are common in patients with SCAD, in addition to prevalent comorbid FMD, migraine, tinnitus, and non-ischaemic pain conditions. These factors may add to developing tailored rehabilitation programmes for patients with SCAD.

     

Systematic review of water fluoridation

ObjectiveTo review the safety and efficacy of fluoridation of drinking water.DesignSearch of 25 electronic databases and world wide web. Relevant journals hand searched; further information requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity.Results214 studies were included. The quality of studies was low to moderate. Water fluoridation was associated with an increased proportion of children without caries and a reduction in the number of teeth affected by caries. The range (median) of mean differences in the proportion of children without caries was −5.0% to 64% (14.6%). The range (median) of mean change in decayed, missing, and filled primary/permanent teeth was 0.5 to 4.4 (2.25) teeth. A dose-dependent increase in dental fluorosis was found. At a fluoride level of 1 ppm an estimated 12.5% (95% confidence interval 7.0% to 21.5%) of exposed people would have fluorosis that they would find aesthetically concerning.ConclusionsThe evidence of a beneficial reduction in caries should be considered together with the increased prevalence of dental fluorosis. There was no clear evidence of other potential adverse effects.     

Frequencies of Dental Anomalies and Their Potential Effect on Determining MNI Counts

Abstract

An examination of the distribution and morphology of supernumerary teeth in North American Bovidae and Cervidae indicates their expected frequency of occurrence in archaeological sites and potential effect on MNI counts.     

Dental treatment strategies in a 40-year-old patient with cleidocranial dysplasia

Oral anomalies and dental treatment in a patient with cleidocranial dysplasia (referred to the dental clinic at the age of 40 years) are presented. Five supernumerary teeth were found in the patient: three in the maxilla in the area of molars and two in the mandibula in the area of premolars. Therapy included surgical exposure of impacted teeth in combination with removal of supernumerary teeth.     

Differences in Primary Hyperparathyroidism Between Pre- and Postmenopausal Women in India

ObjectivePrimary hyperparathyroidism (PHPT) is a common endocrine disorder in women which becomes more prevalent after menopause. In this study, we compared the demographic, clinical, and biochemical variables between premenopausal (pre-M) and postmenopausal (post-M) women with PHPT.MethodsA retrospective analysis (from 2005 to 2019) of enrolled women PHPT patients from an online Indian PHPT registry.ResultsOf the women with PHPT, 232 and 122 were pre-M and post-M, respectively. The number of post-M PHPT cases registered had a 3.3-fold increase in 2015-2019 from 2005-2009 compared with only a 2.5-fold increase in pre-M cases in the same duration. The majority were symptomatic (90%), although pre-M had a higher proportion of symptomatic than post-M (92% vs 85%; P = .04). Pre-M women showed more prevalence of osteitis fibrosa cystica than post-M women (28% vs 13%; P = .03), although hypertension and gallstone disease were seen more frequently in post-M PHPT women. Pre-M women had a significantly higher median PTH (403 vs 246 pg/mL; P = .02) and median alkaline phosphatase (202 vs 145 pg/mL; P = .02) than post-M women, and vitamin D deficiency was more common in pre-M women (58% vs 45%; P = .03). Gland localization, tumor weight, and disease cure rates did not differ according to menopausal status.ConclusionPHPT was more prevalent in pre-M women, although the number of post-M cases had significantly increased in the last 10 years. Pre-M women had generally more severe clinical and biochemical variables than post-M PHPT women.     

Bone Mineral Density of the 1/3 Radius Refines Osteoporosis Diagnosis,Correlates With Prevalent Fractures,and Enhances Fracture Risk Estimates

ObjectiveTo investigate the added value of 1/3 radius (1/3R) for the diagnosis of osteoporosis by spine and hip sites and its correlation with prevalent fractures and predicted fracture risk.MethodsFracture Risk Assessment Tool (FRAX) scores for hip and major osteoporotic fractures (MOF) with/without trabecular bone score were considered proxy for fracture risk. The contribution of 1/3R to risk prediction was depicted via linear regression models with FRAX score as the dependent variable—first only with central and then with radius T-score as an additional covariate. Significance of change in the explained variance was compared by F-test.ResultsThe study included 1453 patients, 86% women, aged 66 ± 10 years. A total of 32% (n = 471) were osteoporotic by spine/hip and 8% (n = 115) by radius only, constituting a 24.4% increase in the number of subjects defined as osteoporotic (n = 586, 40%). Prior fracture prevalence was similar among patients with osteoporosis by spine/hip (17.4%) and radius only (19.1%) (P = .77).FRAX prediction by a regression model using spine/hip T-score yielded explained variance of 51.8% and 49.9% for MOF and 39.8% and 36.4% for hip (with/without trabecular bone score adjustment, respectively). The contribution of 1/3R was statistically significant (P < .001) and slightly increased the explained variance to 52.3% and 50.4% for MOF and 40.9% and 37.4% for hip, respectively.ConclusionReclassification of BMD results according to radius measurements results in higher diagnostic output. Prior fractures were equally prevalent among patients with radius-only and classic-site osteoporosis. FRAX tool performance slightly improved by incorporating radius BMD. Whether this approach may lead to a better fracture prediction warrants further prospective evaluation.     

A cross-sectional survey among patients and prescribers on insulin dosing irregularities and impact of mild (self-treated) hypoglycemia episodes in Spanish patients with type 2 diabetes as compared to other European patients

Background and objectiveIn Spain, data suggest that 13.8% of adults have diabetes. Two important aspects in diabetes management are mild hypoglycemic episodes and poor treatment adherence. This study assesses the impact of missed insulin doses and prevalence of mistimed and reduced insulin doses and mild hypoglycemia in patients with type 2 diabetes treated with basal insulin analogues in Spain, and compares the data collected to pooled data from 8 other European countries (OECs).Materials and methodsGAPP2 was an international, online, cross-sectional study of diabetic patients aged ≥40 years treated with long-acting insulin analogues and their healthcare professionals. Patients and healthcare professionals were recruited from online research panels. Data reported in Spain are compared to pooled data from 8 OECs.ResultsIn Spain, 1–3% of patients reported they had reduced, missed, or mistimed at least one insulin does in the previous month. Significantly more OEC patients reported dosing irregularities (15–23%; all P < 0.01). In Spain, 77% of patients were worried and 59% felt guilty for missing a dose of basal insulin, while 24% reported that they were very worried about nocturnal hypoglycemia. Significantly fewer OEC patients reported worrying (47%; P < 0.01) and feeling guilty (37%; P < 0.01) about missing an insulin dose, or worry about nocturnal hypoglycemia (12%; P < 0.01).ConclusionsIn Spain, patients with type 2 diabetes report fewer dosing irregularities and hypoglycemic episodes as compared to patients from OECs. However, Spanish patients appear to have a reduced quality of life related to hypoglycemia as well as worry and guilt related to insulin dosing irregularities.