Assessment of permanent teeth development in children with multiple persistent primary teeth

Background: Persistent primary teeth (PPT) may occur due to various local factors, or it may develop due to general factors such as systemic diseases and syndromes. Since eruption and dental development are two different processes, it is important to investigate both processes to determine the actual cause of delayed tooth eruption. The study aimed to evaluate the dental development of a group of Turkish children with multiple PPT using the Willems dental age estimation method. Study Design: Digital panoramic radiographs of children and adolescents aged between 9 and 15 years were retrieved, assessed and categorized. A total of 80 radiographs of patients with more than one PPT were selected and matched with children without PPT. Dental age was calculated using the method of Willems et al. All analyses were conducted using the SPSS statistical software. The statistical significance was set at 0.05. Results: The permanent tooth development of children with multiple PPT could be delayed by 0.5–4 years compared to healthy ones. A strong positive correlation was found between the number of PPT and deviation for both females and males (p < 0.001). Conclusion: In conclusion, we found that permanent tooth development of children with multiple PPT could be delayed compared to healthy ones. In addition, as the number of PPT increased, the difference between chronological age and dental age also increased, especially in males.

Persistent primary teeth; Retained tooth; Chronological age; Dental age; Forensic odontology; Willems method

[1] Craddock HL, Youngson CC. Eruptive tooth movement—the current state of knowledge. British Dental Journal. 2004; 197: 385–391.

[2] Cunha RF, Boer FA, Torriani DD, Frossard WT. Natal and neonatal teeth: review of the literature. Pediatric Dentistry. 2001; 23: 158–162.

[3] Nolla CM. The development of the human dentition. ASDC Journal of Dentistry for Children. 1960; 27: 254–266.

[4] Aktan AM, Kara I, Sener I, Bereket C, Celik S, Kirtay M, et al. An evaluation of factors associ ated with persistent primary teeth. European Journal of Orthodontics. 2012; 34: 208–212.

[5] Shapira Y, Kuftinec MM. Intrabony migration of impacted teeth. The Angle Orthodontist. 2003; 73: 738–743.

[6] Liversidge HM. Tooth eruption and timing. A companion to dental anthropology (159–171). 1st edition. John Wiley & Sons, Inc: UK. 2015.

[7] Bockmann MR, Hughes TE, Townsend GC. Genetic modeling of primary tooth emergence: a study of Australian twins. Twin Research and Human Genetics. 2010; 13: 573–581.

[8] O’Connell AC, Puck JM, Grimbacher B, Facchetti F, Majorana A, Gallin JI, et al. Delayed eruption of permanent teeth in hyperimmunoglobuline-mia E recurrent infection syndrome. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2000; 89: 177–185.

[9] Suri L, Gagari E, Vastardis H. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review. American Journal of Orthodontics and Dentofacial Orthopedics. 2004; 126: 432–445.

[10] Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Human Biology. 1973; 45: 211–227.

[11] Willems G, Van Olmen A, Spiessens B, Carels C. Dental age estimation in belgian children: Demirjian’s technique revisited. Journal of Forensic Sciences. 2001; 46: 15064J.

[12] Koç A, Özlek E, Öner Talmaç AG. Accuracy of the London atlas, Willems, and Nolla methods for dental age estimation: a cross-sectional study on Eastern Turkish children. Clinical Oral Investigations. 2021; 25: 4833–4840.

[13] Apaydin BK, Yasar F. Accuracy of the demirjian, willems and cameriere methods of estimating dental age on turkish children. Nigerian Journal of Clinical Practice. 2018; 21: 257–263.

[14] Çarıkcıoglu B, Degirmenci A. Accuracy of the radiographic methods of Willems, Cameriere and Blenkin-Evans on age estimation for Turkish children in the northwest Anatolia region. Australian Journal of Forensic Sciences. 2021; Volume: 1–12.

[15] Taran PK, Olmez A. Prevalence, distribution, and condition of persistent primary teeth in children and adolescents. International Journal of Pedodontic Rehabilitation. 2019; 4: 50–54.

[16] Isık AB, Zafersoy AZ, Uzuner FD. Radiographic evaluation of the distribution and condition of persistent primary teeth. Acta Odontologica Turcica. 2013; 30: 77–84.

[17] Küchler EC, Henklein SD, Proff P, Lepri CP, Perin CP, Paddenberg E, et al. Single nucleotide polymorphisms in cox2 ıs associated with persistent primary tooth and delayed permanent tooth eruption. International Journal of Environmental Research and Public Health 2022; 19: 10047.

[18] Xavier TA, Madalena IR, da Silva RAB, da Silva LAB, Silva MJB, De Rossi A, et al. Vitamin D deficiency is a risk factor for delayed tooth eruption associated with persistent primary tooth. Acta Odontologica Scandinavica. 2021; 79: 600–605.

[19] Oznurhan F, Ekci ES, Ozalp S, Deveci C, Delilbasi AE, Bani M, et al. Time and sequence of eruption of permanent teeth in Ankara, Turkey. Pediatric Dental Journal. 2016; 26: 1–7.

[20] Peedikayil FC. Delayed Tooth Eruption. e-Journal of Dentistry. 2011; 1: 81–86.

[21] Arid J, Xavier TA, da Silva RAB, De Rossi A, da Silva LAB, de Queiroz AM, et al. RANKL is associated with persistent primary teeth and delayed permanent tooth emergence. International Journal of Paediatric Dentistry. 2019; 29: 294–300.

[22] Deepa D, Rana N, Arun Kumar KV. Nonsyndromic bilateral multiple retained primary incisors in mandibular arch: rare case report. Journal of Oral Research and Review. 2016; 8: 79–81.

[23] Kutesa A, Nkamba EM, Muwazi L, Buwembo W, Rwenyonyi CM. Weight, height and eruption times of permanent teeth of children aged 4–15 years in Kampala, Uganda. BMC Oral Health. 2013; 13: 15.

[24] Qin H, Yang FS. Calcitonin may be a useful therapeutic agent for osteoclastogenesis syndromes involving premature eruption of the tooth. Medical Hypotheses. 2008; 70: 1048–1050.

[25] Sujatha G, Sivapathasundharam B, Sivakumar G, Nalinkumar S, Ramasamy M, Prasad T. Idiopathic multiple impacted unerupted teeth: Case report and discussion. Journal of Oral and Maxillofacial Pathology. 2012; 16: 125.

[26] Sletten DW, Smith BM, Southard KA, Casko JS, Southard TE. Retained deciduous mandibular molars in adults: a radiographic study of long-term changes. American Journal of Orthodontics and Dentofacial Orthopedics. 2003; 124: 625–630.

[27] Zuccati GC, Doldo T. Multiple bilateral impactions in an adolescent girl. American Journal of Orthodontics and Dentofacial Orthopedics. 2010; 137: S163–S172.

[28] Cooper SC, Flaitz CM, Johnston DA, Lee B, Hecht JT. A natural history of cleidocranial dysplasia. American Journal of Medical Genetics. 2001; 104: 1–6.

[29] Dalampiras S, Christina B, Stanko P. Full retarded eruption of permanent dentition: report of a rare case (8-year follow up). European Journal of Dentistry and Medicine. 2012; 4: 34–37.

[30] Diz P, Limeres J, Salgado AFP, Tomás I, Delgado LF, Vázquez E, et al. Correlation between dental maturation and chronological age in patients with cerebral palsy, mental retardation, and down syndrome. Research in Developmental Disabilities. 2011; 32: 808–817.

[31] Suda N, Hiyama S, Kuroda T. Relationship between formation/eruption of maxillary teeth and skeletal pattern of maxilla. American Journal of Orthodontics and Dentofacial Orthopedics. 2002; 121: 46–52.

[32] Koshy S, Tandon S. Dental age assessment: the applicability of Demir-jian’s method in South Indian children. Forensic Science International. 1998; 94: 73–85.

[33] Kochhar R, Richardson A. The chronology and sequence of eruption of human permanent teeth in Northern Ireland. International Journal of Paediatric Dentistry. 1998; 8: 243–252.