International Journal of Medical and Health Sciences

Journal Home Page: http://www.ijmhs.net ISSN:2277-4505

Original article

Prevalence and Distribution of Dental anomalies in Thai Orthodontic Patients

Weeraya Tantanapornkul1*

1
Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Muang, Phitsanulok, 65000,Thailand.

ABSTRACT

Purposes: To evaluate the prevalence and distribution of dental anomalies, including other abnormalities in the pre-treatment
panoramic radiographs in a sample of Thai orthodontic patients, which were taken at dental hospital, Faculty of Dentistry,
Naresuan University and private dental clinic in Phitsanulok, Thailand between January, 2012 and October, 2014. Materials and
Methods: A retrospective study was conducted to evaluate the panoramic radiographs. Dental anomalies and other abnormalities
were recorded. The prevalence and distribution of the anomalies were assessed and reported as descriptive statistics. Results: 638
panoramic radiographs were evaluated. Patients were between 13 and 30 years of age (mean 19.2 ± 3.39 years), 39.5 % of patients
had at least one dental anomaly. Dilaceration was the most common (29.16 %), followed by missing tooth (13.17 %), microdontia
(7.21 %), taurodontism (3.29 %), supernumerary tooth (2.66 %), transposition (1.56 %), and the other anomalies (0.155 % – 0.47
%). Conclusion: At least one dental anomaly was found in a sample of Thai orthodontic patients. Dilaceration was the most
common anomaly. The prevalence and distribution of dental anomalies are different between the parts of Thai orthodontic patients
and between the races.

KEYWORDS: Dental anomalies, panoramic, orthodontic patient.

INTRODUCTION

Dental anomalies have long been a concern to dental
profession. Abnormalities in tooth size, shape, and structure
result from disturbances during the morpho-differentiation
stage of development, while ectopic eruption, rotation and
impaction of teeth result from developmental disturbances in
the eruption pattern of the permanent dentition [1]. In
addition, various maxillofacial pathologies can affect the
jaw size, occlusion, diagnosis and treatment plan of
orthodontic patients.
Although orthodontic patients have been reported to have
high rates of dental anomalies, orthodontists often fail to
consider this [2-4]. If not detected, they can complicate
dental and orthodontic treatment. Therefore, orthodontists
and general dental professional should carefully investigate.
Their incidence and degree of expression can provide
important information for phylogenic and genetic studies
and help in the understanding of differences within and
between populations [4]. Several studies have investigated
the prevalence of dental anomalies in various age groups
and race.
Fekonja[5] reported a hypodontia frequency of 11.3% in 212
orthodontically treated children, which was higher than the
Int J Med Health Sci. April 2015,Vol-4;Issue-2
incidence of hypodontia reported in other studies of the
same patients’ age. Altug-Atac and Erdem[2] reported
5.46% of the orthodontic patients in a group of 3,043 had at
least 1 developmental anomaly, while Thongudomporn and
Freer[6] investigated 111 orthodontic patients and found that
74.8% had at least 1 dental anomaly. Endo et al.[7] reported
the high prevalence (8%-10%) of hypodontia (except third
molars) and lateral incisor agenesis of permanent teeth in
Japanese orthodontic patients.
Uslu et al.[3] found no statistically significant correlations
between having a dental anomaly and the type of
malocclusion, except having an impacted tooth or a short
blunt root. Zhu et al.[8] reported the prevalence of
supernumerary teeth by race, which was different between
the white population and the Turkish population [2].
The results of several studies, however, are conflicting. The
discrepancies in their results were attributed to racial
differences, variable sampling techniques, and different
diagnostic criteria. Racial differences were stressed as a
possible main explanation of this variation [4]. In spite of
this variation, a common point between the different studies
was the unavoidable frequency of developmental dental
165
anomalies in every community [2]. The purpose of this
study was to evaluate the prevalence and distribution of
dental anomalies, including other abnormalities in the pre-
treatment panoramic radiographs in a sample of Thai
orthodontic patients.
MATERIALS AND METHODS
The present study has been approved by Institutional
Review Board, Naresuan University. Pre-treatment digital
panoramic radiographs of a sample of Thai orthodontic
patients were retrospectively evaluated. All of the patients
had been referred for radiographic examination at Oral
Radiology Clinic, Dental Hospital, Faculty of Dentistry,
Naresuan University, and private dental clinic in
Phitsanulok, Thailand, between January, 2012 and October,
2014. All of panoramic radiographs were examined on 19.5
inches computer monitor (Samsung Syncmaster E2020X,
Samsung, Thailand) with resolution of 1600x900. The
selection criteria, as follows:
1. Patients with no history of tooth loss due to trauma or
extraction.
2. Patients without metabolic disorders or syndromes
affecting bone metabolism and/or tooth formation such
as Down’s syndrome, ectodermal dysplasia.
3. Patients without cleft lip and palate, dentofacial
deformities.
4. Patients with no history of previous orthodontic
treatment.
5. Good quality panoramic radiographs.
6. Complete root formation of all permanent teeth
appeared on panoramic radiographs (except third
molar).
Demographic data (age and sex) of the patients were record.
Panoramic radiographs were evaluated by a radiologist. The
following dental anomalies were assessed:
1. Number abnormalities: supernumerary tooth, missing
tooth
2. Size abnormalities: microdontia, macrodontia
3. Shape abnormalities: gemination, fusion,
concrescence, dens evaginatus, dens invaginatus,
taurodontism, dilacerations
4. Structural abnormalities: amelogenesis imperfecta,
enamel hypoplasia, dentinogenesis imperfect,
odontogenesis imperfect, dentinal dysplasia
5. Other findings: such as embedded tooth, ectopic
eruption, bifid root
Int J Med Health Sci. April 2015,Vol-4;Issue-2
Statistical analysis
Descriptive statistic (Statistical Package for Social Science:
SPSS) was used to evaluate the prevalence and distribution
of dental anomalies and other findings. Percentages and
means were also calculated.
RESULTS
The present study was performed for evaluation of
prevalence and distribution of dental anomalies and other
findings in the group of 638 pre-orthodontic treatment
patients, which composed of 167 males (26.2%) and 471
females (73.8%). Age ranged between 13 and 30 years
(mean 19.2 ± 3.39). The total prevalence and distribution of
dental anomalies is shown in Table 1.
In 638 patients, shape abnormalities were most found
(34.64%), followed by number abnormalities (15.83%) and
size abnormalities (7.52%) respectively. In addition, 252 of
638 patients (39.50%) exhibited one anomaly, 90 (14.11%)
patients showed two anomalies and 25 (3.92%) patients
displayed more than two anomalies (Table 2).
Number abnormalities
a)Hypodontia (Missing tooth)
It was found that 84 out of 638 patients had missing tooth
(18 males and 66 females, Table 1). Prevalence and
distribution of missing tooth is presented in Table 3. Except
for third molar, the most common missing tooth was the
lower incisor (26.32%), followed by lower premolar
(24.81%) and upper incisor (19.55%) respectively. It was
found that missing tooth occurred in mandible (55.64%)
more often than in the maxilla (44.36%).
Among the hypodontia group, the percentage of patients
with one, two, three or more missing teeth were 60.71,
29.76, 2.38 and 5.95 respectively. The highest number of
congenitally missing teeth was 9 in only one patient (0.16%
of total number of patients).
b)Hyperdontia
Hyperdontia, including supernumerary tooth and mesiodens,
was seen in 17 patients. The most frequent hyperdontia was
upper left posterior tooth (8 patients, 36.35%), followed by
upper anterior teeth (5 patients, 22.73%), lower left posterior
teeth (4 cases, 18.17%), lower right posterior teeth (3 cases,
13.65%) and upper right posterior teeth (2 cases, 9.10%)
respectively (Table 4).
Regarding the number of supernumerary tooth, the ratio of
male to female was 2.14 to 1, the ratio of upper to lower and
anterior to posterior teeth were 2.14 to 1 and 1 to 3.4
respectively.
166
Table 1: Prevalence and distribution of dental anomalies in study group
____________________________________________________________________________
Dental anomalies Male (%) Female (%) Total
____________________________________________________________________________

Number abnormalities:
Missing tooth 18 (2.83) 66 (10.34) 84 (13.17)
Supernumerary tooth 10 (1.56) 7 (1.10) 17 (2.66)

Size abnormalities:
Macrodontia 1 (0.155) 1 (0.155) 2 (0.31)
Microdontia 13 (2.04) 33 (5.17) 46 (7.21)

Position abnormalities:
Ectopic eruption 2 (0.31) 8 (1.25) 10 (1.56)

Shape abnormalities:
Fusion 1 (0.155) 0 (0) 1 (0.155)
Gemination 1 (0.155) 1 (0.155) 2 (0.31)
Taurodontism 4 (0.63) 17 (2.66) 21 (3.29)
Dilaceration 44 (6.90) 142 (22.26) 186 (29.16)
Dens invaginatus 0 (0) 7 (1.10) 7 (1.10)
Dens evaginatus 1 (0.155) 2 (0.31) 3 (0.47)
Dentin dysplasia 0 (0) 1 (0.155) 1 (0.155)

Other findings:
External root resorption 1 (0.155) 0 (0) 1 (0.155)
Internal root resorption 1 (0.155) 0 (0) 1 (0.155)
Pulp stone 0 (0) 1 (0.155) 1 (0.155)
Total 97 (15.2) 286 (44.82) 383 (60.02)
_____________________________________________________________________________

Table 2: Frequencies of dental anomalies evaluated from panoramic radiograph

______________________________________________________________________________
Frequencies of anomalies Male (%) Female (%) Total (%)
______________________________________________________________________________
1 anomaly 86 (13.48) 166 (26.02) 252 (39.50)
2 anomalies 14 (2.19) 76 (11.92) 90 (14.11)
More than 2 anomalies 7 (1.10) 18 (2.82) 25 (3.92)

Total 107 (16.77) 260 (40.76) 367 (57.53)

______________________________________________________________________________

Table 3: Prevalence and distribution of missing tooth

______________________________________________________________________________
Location Male (%) Female (%) Total (%)
______________________________________________________________________________

Upper incisor 4 (3.01) 22 (16.54) 26 (19.55)

Upper canine 2 (1.50) 12 (9.02) 14 (10.52)
Upper premolar 5 (3.76) 14 (10.53) 19 (14.29)
Lower incisor 3 (2.26) 32 (24.06) 35 (26.32)
Lower canine 1 (0.75) 5 (3.76) 6 (4.51)
Lower premolar 6 (4.51) 27 (20.30) 33 (24.81)

Total 21 (15.79) 112 (84.21) 133 (100)

______________________________________________________________________________

Int J Med Health Sci. April 2015,Vol-4;Issue-2 167

Table 4: Prevalence and distribution of supernumerary tooth
_______________________________________________________________________________
Location Male (%) Female (%) Total (%)

_______________________________________________________________________________
Maxilla
Upper right posterior 1 (4.55) 1 (4.55) 2 (9.10)
Upper anterior 4 (18.17) 1 (4.55) 5 (22.73)
Upper left posterior 4 (18.17) 4 (18.17) 8 (36.35)

Mandible
Lower right posterior 2 (9.10) 1 (4.55) 3 (13.65)
Lower left posterior 4 (18.17) 0 (0) 4 (18.17)

Total 15 (68.18) 7 (31.82) 22 (100)

______________________________________________________________________________

Size abnormalities (macrodontia and microdontia)
Regardless of the third molar, macrodontia was found in
only 2 patients (0.31%, 1 male and 1 female). On the other
hand, microdontia was much more found in 46 patients
(7.21%). We found that in 66 teeth with microdontia, 65
(98.49%) were upper lateral incisor and 1 (1.51%) was
upper premolar. It was also observed that 20 out of 46
patients had bilateral peg-shaped upper lateral incisor (Table
5).

Table 5: Prevalence and distribution of microdontia

______________________________________________________________________________
Location Male (%) Female (%) Total (%)
___________________________________________________________________________
Upper lateral incisor 19 (28.79) 46 (69.70) 65 (98.49)
Upper premolar 1 (1.51) 0 (0) 1 (1.51)

Total 20 (30.30) 46 (69.70) 66 (100)

______________________________________________________________________________

Position abnormalities (0.155%), gemination (0.31%), dens invaginatus (1.10%),

Ectopic eruption was observed in 2 males and 8 females,
with a total prevalence of 1.56% (Table 1). All of the
patients in this group had ectopic eruption of upper canine,
the ratio of male to female was 1 to 4. Transposition was not
found in this study.
Shape abnormalities
Shape abnormalities were the most frequent dental
anomalies observed in this study. Dilaceration had highest
prevalence (186 patients, 29.16%, Table 1). According to
Table 6, most of dilacerations occurred in upper premolar
(73 of 302 teeth, 24.17%), followed by lower molar (59
teeth, 19.53%) and upper incisor (58 teeth, 19.21%)
respectively.
Taurodontism was the second most frequent of shape
abnormalities (21 patients, 3.29%). Most of taurodontism
appeared in lower second molar (17 patients, 80.95%), the
ratio of male to female was 1 to 4.25. The other shape
abnormalities observed in this study including fusion
dens evaginatus (0.47%) and dentin dysplasia (0.155%).
Other dental anomalies
Other radiographic findings of dental anomalies observed in
the present study were; 1 patient with internal root
resorption, 1 patient with external root resorption and 1
patient with pulp stone.
Other abnormalities
Out of 638 patients, other abnormalities were presented in
Table 7. Embedded tooth was found in 38 patients (5.59%),
followed by bifid root of lower premolar (5 cases, 0.78%),
three roots of lower first molar (2 cases, 0.31%) and
odontoma of upper molar tooth (2 cases, 0.31%)
respectively.
In the present study, it was observed that dilacerations was
the most common dental anomalies (29.16%), followed by
missing tooth (13.17%), microdontia (7.21%), taurodontism
(3.29%) and supernumerary tooth (2.66%) respectively
(Table 8).

Int J Med Health Sci. April 2015,Vol-4;Issue-2 168

Table 6 Prevalence and distribution of dilaceration
____________________________________________________________________________

Location Male (%) Female (%) Total (%)

____________________________________________________________________________

Maxilla
Incisor 12 (3.97) 46 (15.24) 58 (19.21)
Canine 9 (2.98) 34 (11.26) 43 (14.24)
Premolar 10 (3.31) 63 (20.86) 73 (24.17)
Molar 5 (1.66) 10 (3.31) 15 (4.97)

Mandible
Incisor 0 (0) 2 (0.66) 2 (0.66)
Canine 2 (0.66) 7 (2.32) 9 (2.98)
Premolar 8 (2.65) 35 (11.59) 43 (14.24)
Molar 26 (8.61) 33 (10.92) 59 (19.53)

Total 72 (23.84) 230 (76.16) 302 (100)

______________________________________________________________________________

Table 7: Other abnormalities on panoramic radiograph among the study subjects

______________________________________________________________________________
Abnormalities Cases (%) Location

______________________________________________________________________________

Embedded tooth 38 (5.59) upper and lower incisors

upper and lower premolars
lower molars
Bifid root 5 (0.78) lower premolars
Three root 2 (0.31) lower molars
Odontoma 2 (0.31) upper molars
______________________________________________________________________________

Table 8: Prevalence order of dental anomalies

______________________________________________________________________________

Order Dental anomalies Cases (%)

___________________________________________________________________________
1 Dilaceration 186 (29.16)
2 Missing tooth 84 (13.17)
3 Microdontia 46 (7.21)
4 Taurodontism 21 (3.29)
5 Supernumerary tooth 17 (2.66)
____________________________________________________________________________

DISCUSSION more influence on the prevalence of dental anomalies than

9-11 age group showed more suffering from atopy
compared to age group 12-14 year old. These result were
consistent with the Although several studies have
emphasized the prevalence and distribution of dental
anomalies in orthodontic patients, their conflicting results
can be explained by racial differences, sampling techniques
and diagnostic criteria. They could also be explained by
local environment influences and nutrition [2,4]. Congenital
anomalies of the teeth often appear together with
craniofacial discrepancies generating complicated
therapeutic problems [9]. Environmental factors could have
Int J Med Health Sci. April 2015,Vol-4;Issue-2
racial factors in every population [10]. Although defects in
certain genes are considered the main causes, etiologic
events in the pre- and postnatal periods have also been
blamed for dental anomalies [11]. Influences on teeth may
begin before or after birth, and primary and permanent teeth
can both be affected [12].
The present study was performed by evaluation of
panoramic radiograph in pre-orthodontic treatment patients.
It was found that 39.50% of 638 patients (may be implied
that every 2-3 Thai orthodontic patients) had at least one
dental anomaly. Uslu et al.[3] reported 40.3% of 900
169
Turkish patients with one dental anomaly, whereas
Thongudomporn & Freer[6] reported 74.78% of 111
patients with the same condition. To the author’s
knowledge, there has been only one study of the prevalence
and distribution of dental anomalies in Thai population,
which was performed in 570 patients (124 males and 446
males) [13]. However, their results were different from this
study. In addition, differences in the prevalence and
distribution of dental anomalies were observed between the
present study and previous studies in various races as
follows.
Hypodontia is one of the most common dental anomalies in
orthodontic patients. The prevalences of hypodontia in
orthodontic patients were different in various group of
population. It ranges from 2.6% in Turkey[2], 5.5% in
Mexico[14], 6.3% in Brazil[15], 8.5% in Japan[7], 11.1% in
Korea[16], 13.7% in Thai (this study) to 14.7% in Hungary
[17].
Prevalence of hypodontia in this study was 13.7% 638
patients, which was lower than that of the results of
Kositbowornchai et al.[13] (26.4% of 570 Thai patients).
Difference region and ethnic of population may be
explained for the different results. In our study, the most
commonly missing tooth was lower incisor (26.32%),
followed by lower premolar (24.81%) and upper incisor
(19.55%). The second and third most common missing teeth
of our study were different from Kositbowornchai et al.[13]
(upper lateral incisor and lower second premolar
respectively). We also found that most common missing
tooth in our study was different from the others; upper
lateral incisor in Turkish[2], Indian[4], Mexican[14] and
Brazilian[15], and lower second premolar in Japanese [7].
However, our result was in accordance with study of Chung
et al.[16] in Korean, for the two most common missing
teeth.
Dental anomalies such as tooth agenesis are frequently
associated with other anomalies such as microdontia,
delayed dental development, and some discrete tooth
ectopia, perhaps because a certain genetic mutation causes a
series of different phenotypic expression [18]. Mutation in
genes such as MSX, PAX 9 or TGFA are reported to cause
hypodontia in different racial groups [19].
The prevalence of supernumerary tooth is less common than
missing tooth, and is differ between races. Uslu et al.[3]
reported the prevalence of 0.3% in Turkey, Gupta et al.[4]
reported the prevalence of 0.62% in India, Zhu et al.[8]
found the prevalence of hyperdontia ranged from 1% to 3%
among the white population. A significant difference was
also observed between the present study (2.66%) and the
study by Kositbowornchai et al.[13] (13.17%) in Thai
population. This may be explained by the different part
living (North and Northeast parts of Thailand), local
environment, nutrition, inclusion criteria, diagnostic criteria,
and study design.
In the present study we found that the most common
supernumerary tooth was upper left posterior tooth (36.35%,
8 of 22 teeth). Our result was different from others, which
reported that the most common supernumerary teeth was
upper anterior tooth.[3,4,6,13] We found mesiodens in 5 of
638 patients (0.78%). The prevalence of mesiodens in
orthodontic patients ranged between 0.3% to 1.8%[2,6],
Int J Med Health Sci. April 2015,Vol-4;Issue-2
which is not significantly different from the general
population (0.15%-1.9%) [20].
Macrodontia is a rare abnormality of teeth and very much
less common than microdontia [2]. In the present study, we
found 0.31% of macrodontia and 7.21% of microdontia. The
most frequently found of microdontia was upper lateral
incisor (98.49%), which was in agreement with other studies
[2,6,13]. The prevalence of microdontia had been reported
to increase over time [10]. This was attributed to the rate of
evolution, local environmental factors and criteria in
selecting the study groups [2].
Transposition is a less common anomaly which always
found in permanent teeth (prevalence 0.3%-0.4%). It was
reported that the upper teeth always had transposition
including: canine and premolar, canine and lateral incisor,
lateral and central incisor [21]. Transposition may occur
with other abnormalities such as aplasia, peg-shaped lateral
incisor and deciduous teeth retention [22]. Our study result,
in agreement with Yilmaz et al.[21], the most frequently
found transposed teeth were upper canine and premolar.
However, Kositbowornchai et al.[13] reported that canine
and first premolar were the most common found tooth
transposition. Even though studying in the same race (Thai),
the results were different.
We also observed ectopic eruption of upper canine in 7
patients without statistically significant difference between
males and females.
Shape abnormalities were the most common dental
anomalies in the present study (34.64%, 221 of 638
patients). We found that the most frequently found shape
abnormality, and also the most common dental anomaly in
this study, was dilaceration (29.16%, 186 0f 638 teeth). The
prevalence of dilaceration in our study was higher than
others (1.8%-3.78%) [3,6,23]. The most common
dilaceration in our study was upper premolar (24.17%),
followed by lower molar and upper incisor respectively.
There was no reported of dilaceration in the other study in
Thai population [13]. The etiology of dilaceration resulting
from an altered position of the tooth crown relative to the
developing root and root sheath [24].
There also many factors that cause dilaceration including
scar formation, primary tooth germ anomaly, facial clefting,
advanced root canal infections, ectopic development of
tooth germ and lack of space, anatomic structure, cyst,
tumor or odontogenic hamartoma, orotracheal intubation,
mechanical interference with eruption, tooth transplantation,
extraction of primary tooth and hereditary factors [25].
Tooth root dilaceration can increase the treatment difficulty
by impeding dental implant placement, root apex access
through the root canal system, tooth extraction, affect crown
root ratios/ periodontal support, orthodontic anchorage and
root positioning within the bone [26].
The definition of root dilaceration varies in the relevant
literature and depends on the criteria set by each author.
Some authors describing dilaceration as a 90º or greater root
deflection in relation to the tooth or root axis. Others
consider a tooth dilacerated when its apical deviation is
equal or exceeds 20º in relation to the normal tooth axis
[27]. The high prevalence of dilaceration in our study
comparing with the others can be explained by different
diagnostic criteria. We considered a tooth dilacerated when
170
its apical deviation is equal or exceeds 20º in relation to
normal tooth axis as defined by Chohayeb [27]. Thus, this
criteria may be the possibility reason of the high prevalence
in the present study.
The second most shape abnormality found in our study was
taurodontism (3.29%), observed mostly in lower second
molar. Our result was not in accordance with Darwazeh et
al. who reported the most common found taurodontism in
upper second molar. This dissimilarity might be related to
racial variations. Prevalence of taurodontism was not
observed in the study of Kositbowornchai et al [13].
Dens invaginatus was found 1.1% in our study, most
frequently in upper lateral incisor (57.1%), in agreement
with Hülsmann [28]. Although dens invaginatus is not
common, there can be severe difficulties related to tooth
anatomy during endodontic treatment [23,28]. Therefore,
orthodontists should be aware of this anomaly in making
decisions about extractions.[3] On the other hand, dens
invaginatus is not considered a risk factor for apical root
resorption during orthodontic tooth movement, although
invaginated teeth have malformed roots more often than
noninvaginated teeth [29].
We found dens evaginatus in only 0.47% of the patients.
Dens evaginatus occurs most commonly in people of
Mongoloid origin, with an average incidence of 2.2% [30].
Uslu et al.[3] reported higher prevalence of dens evaginatus
(6.2%) in Turkish. Early diagnosis of dens evaginatus is
important so that loss of vitality during orthodontic therapy
can be prevented, and treatment alternatives can be
considered. In the orthodontic treatment plan, extraction of a
tooth involving dens evaginatus might be considered so that
the anomalous tooth, rather than an unaffected one, is
extracted [3].
The very low rates of internal and external root resorptions,
and pulp stone (0.155% for each) were observed in the
present study. There also hardly found in other reports.
Regardless impacted third molars, we found embedded
tooth, bifid root, three roots and odontoma. Surgical
management of embedded tooth or odontoma is depend on
decision of orthodontist and/ or oral surgeon.
CONCLUSION
Dental anomalies can be detected easily by a careful
evaluation of routine pretreatment diagnostic tool such as
panoramic radiograph. Dilaceration was the most common
anomaly in the present study. The prevalence and
distribution of dental anomalies are different between the
parts of Thai orthodontic patients and between the races.
The further studies of molecules and molecular mechanisms
operating in the craniofacial region during tooth
development are important in finding out the causes of
them.
REFERENCES
1. Proffit WR. The development of orthodontic problems.
In: Proffit WR, Fields HW, Sarver DM. editor.
Contemporary orthodontics. 4nd ed. St.Louis: Mosby;
2007. P. 27-130.
Int J Med Health Sci. April 2015,Vol-4;Issue-2
2. Altug-Atac AT, Erdem D. Prevalence and distribution of
dental anomalies in orthodontic patients. Am J Orthod
Dentofacial Orthop 2007;131:510-4.
3. Uslu O, Akcam MO, Evirgen S, Cebeci I. Prevalence of
dental anomalies in various malocclusions. Am J Orthod
Dentofacial Orthop 2009;135:328-35.
4. Gupta SK, Saxena P, Jain S, Jain D. Prevalence and
distribution of selected developmental dental anomalies
in an Indian population. J Oral Science 2011;53:231-8.
5. Fekonja A. Hypodontia in orthodontically treated
children. Eur J Orthod 2005;27:457-60.
6. Thongudomporn U, Freer TJ. Prevalence of dental
anomalies in orthodontic patients. Aust Dent J
1998;43:395-8.
7. Endo T, Ozoe R, Kubota M, Akiyama M, Shimooka S.
A survey of hypodontia in Japanese orthodontic patients.
Am J Orthod Dentofacial Orthop 2006;129:29-35.
8. Zhu JF, Maecushamer M, King DL, Henry RJ.
Supernumerary and congenitally absent teeth: a literature
review. J Clin Pediatr Dent 1996;20:87-95.
9. Basdra EK, Kiokpasoglou MN, Komposch G.
Congenital tooth anomalies and malocclusions: a genetic
link?. Eur J Orthod 2001;23:145-51.
10. Montasser MA, Taha M. Prevalence and distribution of
dental anomalies in orthodontic patients. Orthodontics
2012;13:52-9.
11. Fardi A, Kondylidou-Sidira M, Bachour Z, Parisis N,
Tsirlis A. Incidence of impacted and supernumerary
teeth-A radiographic study in a North Greek population.
Med Oral Patol Oral Cir Bucal 2011;16:e56-61.
12. Guttal KS, Naikmasur VG, Bhaegava P, Bathi RJ.
Frequency of developmental dental anomalies in the
Indian population. Eur J Dent 2010;4:263-9.
13. Kositbowornchai S, Keinprasit C, Poomat N. Prevalence
and distribution of dental anomalies in pretreatment
orthodontic Thai patients. Khonkaen Dent J 2010;2:92-
100.
14. Silva Meza R. Radiographic assessment of congenitally
missing teeth in orthodontic patients. Int J paediatr Dent
2003;13:112-6.
15. Gomes R, da Fonseca J, Paula L, Faber J, Acevedo A.
Prevalence of hypodontia in orthodontic patients in
Brasilia, Brazil. Eur J Orthod 2010;32:302-6.
16. Chung C, Han J, Kim K. The pattern and prevalence of
hypodontia in Koreans. Oral Diseases 2008;14:620-5.
17. Gabris K, Fabian G, Kaan M, Rozsa N, Tarjan I.
Prevalence of hypodontia and hyperdontia in
paedodontic and orthodontic patients in Budapest.
Community Dental Health 2006;23:80-2.
18. Garib DG, Alencar BM, Lauris JRP, Baccetti T.
Agenesis of maxillary lateral incisors and associated
dental anomalies. Am J Orthod Dentofacial Orthop
2010;137:732.e1-e6.
171
19. Vieira AR, Meira R, Modesto A, Murray JC. MSX 1,
PAX 9, and TGFA contribute to tooth agenesis in
humans. J Dent Res 2004;83:723-7.
20. Russel K, Folwarezna M. Mesiodens-diagnosis and
management. J Can Dent Assoc 2003;69:362-6.
21. Yilmaz HH, Turkkahraman H, Sayin M. Dental
transposition as a disorder of genetic origin. Eur J
Orthod 2006;28:145-51.
22. Budai M, Fiezere I, Gabris K, Tarjan I. Frequency of
transposition and its treatment at the Department of
Pedodontics and Orthodontics of Semmelweis
University in the last five years. Fogorvosi Szemle
2003;96:21-4.
23. Hamasha AA, Al-Khateeb T, Darwazeh A. Prevalence
of dilacerations in Jordanian adults. Int Endod J
2002;35:910-2.
24. Standerwick RG. A possible etiology for the dilaceration
and flexion of permanent tooth roots relative to bone
remodeling gradients in alveolar bone. Dent Hyp
2014;5:7-10.
25. Hamid J, Paul VA. Dilaceration :Review of an
endodontic challenge. J of Endod 2007;33:1025-30.
Int J Med Health Sci. April 2015,Vol-4;Issue-2
26. Darwazeh AM, Hamasha AA, Pillai K. Prevalence of
taurodontism in Jordanian dental patients.
Dentomaxillofac Radiol 1998;27:163-5.
27. Chohayeb AA. Dilaceration of permanent upper lateral
incisors: frequency, direction, and endodontic treatment
implications. Oral Surg Oral Med Oral Pathol
1983;55:519-20.
28. Hülsmann M. Dens invaginatus: aetiology,
classification, prevalence, diagnosis, and treatment
considerations. Int Endod J 1997;30:79-90.
29. Mavragani M, Apisariyakul J, Brudvik P, Selvig AK. Is
mild dental invagination a risk factor for apical root
resorption in orthodontic patients?. Eur J Orthod
2006;28:307-12.
30. McCulloch KJ, Mills CM, Greenfeld RS, Coil JM. Dens
evaginatus from an orthodontic perspective: report of
several clinical cases and review of literature. Am J
Orthod Dentofacial Orthop 1997;112:670-5.
_______________________________________________
*Corresponding author: Weeraya Tantanapornkul
E-Mail: weeraya_t@yahoo.com
172