This report describes the unusual appearance seen on a panoramic radiograph of an orthodontic patient which the authors argue may represent ectopia or concomitant hypohyperdontia of the mandibular premolar teeth.
A literature review describes the frequency of such anomalies in this area from previous studies.
The presenting features of the patient and the differential diagnoses are explored. Treatment planning is discussed and treatment carried out in this particular case is detailed.
The unusual symmetrical bilateral anomalies in this patient may point to a genetic determinant of tooth germ position and/or movement.
CahillDRHistological changes in the bony crypt and gubernacular canal of erupting permanent premolars during deciduous premolar exfoliation in beagles. J Dent Res1974; 53 (4): 786–91.
4.
SuttonPRMigrating nonerupted mandibular premolars: a case of migration into the coronoid process. Oral Surg Oral Med Oral Pathol1968; 25(1): 87–98.
5.
PolderBJ, Van't HofMA, Van der LindenFP, Kuijpers-JagtmanAM. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol2004; 32(3): 217–26.
6.
MattheeuwsN, DermautL, MartensGHas hypodontia increased in Caucasians during the 20th century? A meta-analysis. Eur J Orthod2004; 26(1): 99–103.
7.
ArteS, NieminenP, PirinenS, ThesleffI, PeltonenLGene defect in hypodontia: exclusion of EGF, EGFR, and FGF-3 as candidate genes. J Dent Res1996; 75(6): 1346–52.
8.
ArteS, NieminenP, ApajalahtiS, HaavikkoK, ThesleffI, PirinenSCharacteristics of incisor-premolar hypodontia in families. J Dent Res2001; 80(5): 1445–50.
9.
BuenviajeTM, RappRDental anomalies in children: a clinical and radiographic survey. J Dent Child1984; 51(1): 42–46.
10.
BrookAHDental anomalies of number, form and size: their prevalence in British schoolchildren. J Int Assoc Dent Child1974; 5(2): 37–53.
11.
KinironsMJUnerupted premaxillary supernumerary teeth. A study of their occurrence in males and females. Br Dent J1982; 153(3): 110.
12.
NazifMM, RuffaloRC, ZulloTImpacted supernumerary teeth: a survey of 50 cases. J Am Dent Assoc1983; 106(2): 201–04.
13.
LiuJFCharacteristics of premaxillary supernumerary teeth: a survey of 112 cases. J Dent Child1995; 62(4): 262–5.
14.
VichiM, FranchiLAbnormalities of the maxillary incisors in children with cleft lip and palate. J Dent Child1995; 62 (6): 412–17.
15.
BaccettiTA controlled study of associated dental anomalies. Angle Orthod1998; 68(3): 267–74.
16.
CamilleriGEConcomitant hypodontia and hyperodontia. Case report. Br Dent J1967; 123(7): 338–39.
17.
AcerbiAG, de FreitasC, de MagalhaesMH. Prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome. Spec Care Dentist2001; 21 (2): 75–78.
18.
ChowKM, O'DonnellD.Concomitant occurrence of hypodontia and supernumerary teeth in a patient with Down syndrome. Spec Care Dentist1997; 17(2): 54–57.
19.
SharmaAA rare non-syndrome case of concomitant multiple supernumerary teeth and partial anodontia. J Clin Pediatr Dent2001; 25(2): 167–69.
20.
IsaacsonKG, ThomAR (Eds). Orthodontic Radiographs Guidelines (Guidelines for the Use of Radiographs in Clinical Orthodontics). British Orthodontic Society, August 2001.
21.
WassersteinA, BrezniakN, ShalishM, HellerM, RakoczMAngular changes and their rates in concurrence to developmental stages of the mandibular second premolar. Angle Orthod. 2004; 74(3): 332–36.
22.
ThomasBL, SharpePTPatterning of the murine dentition by homeobox genes. Eur J Oral Sci. 1998; 106 Suppl 1: 48–54.
23.
TuckerAS, MarkhamHJ, GreenP, DohertyP, SharpePTA novel approach for inhibiting growth factor signalling in murine tooth development. Inhibition of FGF's. Eur J Oral Sci. 1998; 106 Suppl 1: 122–25.
24.
ThomasBL, LiuJK, RubensteinJL, SharpePTIndependent regulation of Dlx2 expression in the epithelium and mesenchyme of the first branchial arch. Development. 2000; 127(2): 217–24.
25.
EskeliR, Laine-AlavaMT, HausenH, PahkalaRStandards for permanent tooth emergence in Finnish children. Angle Orthod1999; 69(6): 529–33.
