Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 28001

AbstractCase ReportDiscussionConclusionReferences
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Dentistry
Year : 2010 | Month : December | Volume : 4 | Issue : 6 | Page : 3627 - 3631

Concomitant occurrence of hypodontia and microdontia in a single case

SUJATA.M. BYAHATTI*

*MDS, Department(s) and institution(s): Reader, Department of Oral medicine and Radiology,Maratha mandals N.G.Halgekar college of dental sciences and research centre, Belgaum, Karnataka,india

Correspondence Address :
Dr. Sujata M Byahatti
Plot no 49, sector # 9, Malmaruti Extn, Belgaum-590016
Phone numbers: Mobile: 9731589981 Res: 08312456931
E-mail address: sujatabyahatti@rediffmail.com

Abstract

Developmentally missing teeth may also be the result of numerous independent pathological mechanisms that can affect the orderly formation of the dental lamina, failure of a tooth germ to develop at the optimal time, the lack of necessary space imposed by a malformed jaw, and a genetically determined disproportion between the tooth mass and the jaw size. Clinically, hypodontia in the permanent dentition, excluding the third molars, is found in 3-10% of the population. Hypodontia is more frequently found in Asians and Native Americans. One of the commonest forms of localized microdontia is that which affects the maxillary lateral incisor, a condition called Peg laterals. The next tooth which can be affected is the third molars. Few cases of microdontia in canines have been reported. The following article throws light on the Concomitant occurrence of hypodontia and microdontia in a single case.

Keywords

Anodontia, Microdontia, Hypodontia

Introduction
Microdontia is a condition where the teeth are smaller than the normal size, which may involve all the teeth or be limited to a single tooth or a group of teeth. Often the lateral incisors and third molars may be small (1). Generalized microdontia is extremely rare, although it does occur in some patients with dwarfism(2). Supernumerary teeth may also be microdonts. Hypodontia refers to the developmentally missing single or multiple teeth (1). Many have reported these anamolies individually, but very few cases where combinations of these anomalies together have been mentioned. One such concomitant occurrence has been reported and discussed below.

Case Report

A 32 year old apparently healthy male patient visited our department with a chief complaint of decayed teeth. The patient was moderately built, with no other clinical signs or symptoms. There was no relevant family/medical history or local lymph node enlargement. On intraoral examination, the entire mucosa appeared apparently normal. The upper anterior quadrant showed microdontic lateral and canines on both the right and the left sides. The lower anterior quadrant showed retained central incisors and canines (Table/Fig 1). OPG showed the same anomalies in a wider range, with the missing permanent tooth buds with respect to the lower anteriors (Table/Fig 2). As per the above findings, the diagnosis of hypodontia with microdontia was made.

Discussion

The expression of developmentally missing teeth may range from the absence of one or a few teeth (hypodontia), to the absence of numerous teeth (oligodontia) and to the failure of all teeth which are to develop (Anodontia) (1). Developmentally missing teeth may also be the result of numerous independent pathological mechanisms that can affect the orderly formation of the dental lamina, the failure of a tooth germ to develop at the optimal time, the lack of necessary space imposed by a malformed jaw, and a genetically determined disproportion between the tooth mass and the jaw size (2).

Clinically, hypodontia in the permanent dentition, excluding the third molars, is found in 3-10% of the population. Hypodontia is more frequently found in Asians and Native Americans. Although missing primary teeth are relatively uncommon, when one tooth is missing, it is usually a maxillary incisor. The most common missing teeth are the third molars, the second premolars and the maxillary and the mandibular central and lateral incisors (1). The absence may be either unilateral or bilateral. Children who have developmentally missing teeth tend to have more than one tooth absent and more than one morphological group (Incisors, premolars and molars) involved. However, it must be kept in mind that the development of teeth may vary markedly among the patients. The eruption of some teeth may be developmentally delayed by a number of years after the established time. The differential diagnosis for hypodontia includes ectodermal dysplasia which is a inherited disorder and it results in the absence of teeth (1) .

Although the aetiology of single missing teeth is unknown, a familial tendency for this defect is present in many instances. Graber (2), while reviewing the congenital absence of teeth, reported the accumulating evidence, that it is actually the result of one or more point mutations in a closely linked polygenic system. It is most often transmitted in an autosomal dominant pattern with incomplete penetrance and variable expressivity.

Reports on the etiology, prevalence, severity and the location of hypodontia within families have found out the roles of genetic and environmental factors, by investigating the relationship between the severity and the distribution of hypodontia between family members, and any discernable effect on maternal health during pregnancy and birth weight (3). 117 first degree relatives of 41 index patients were examined clinically and radiographically to identify the presence, severity and the location of hypodontia. The number and the location of the missing teeth of the patients were not related to the number and location of the missing teeth in their parents or siblings. The expression of hypodontia within a family was not affected by maternal health during pregnancy. The variation which was found in the expression of hypodontia within families, suggests that its occurrence is not solely determined by genetic factors, but that epigenetic and environmental factors also are probably important. This finding is consistent with a multifactorial aetiology for this condition.
The concepts for the treatment (4) of adolescent patients with missing permanent teeth, where the condition of missing permanent teeth was observed with syndromes or was frequently hereditarily propagated in families rather than normal individuals.

The aesthetic and functional rehabilitation (5) of a patient with nonsyndromic oligodontia was reported from China, where Oligodontia (severe partial anodontia) was reffered to as a developmental dental anomaly. It is either an isolated trait or part of a syndrome. Oligodontia is characterized by the congenital absence of more than six permanent teeth except the third molars. Treatment involved would be surgical techniques, but less severe cases can be treated conventionally in a normally equipped dental office.

The prevalence of hypodontia (6) and developmental malformation of permanent teeth in Saudi Arabian schoolchildren has shown that congenital malformations were more in the permanent teeth of Saudi Arabian male children. Five-hundred schoolchildren were investigated after being selected randomly from Riyadh city. The age group of the examined sample ranged from 13 years and 6 months to 14 years and 6 months. Clinical and radiographical examinations were performed. The findings indicated that hypodontia was present in about 4 per cent of the children; the most frequently affected teeth were the mandibular second premolars, the maxillary laterals, and the maxillary second premolars. Tooth malformations, mainly peg-shaped upper lateral incisors, were also observed in about 4 per cent of the sample.

A retrospective literature review (7) was carried out to determine the prevalence of hypodontia and the current knowledge of the associated aetiological factors. The reported studies vary widely in their reports of prevalence and the reported rates were found to vary from 2.6% to 11.3%. Racial differences have been determined. Studies on Caucasians showed that the mandibular second premolars and the maxillary lateral incisors were the most frequently recorded absent teeth and in Asian studies, the mandibular incisor was the most frequently recorded absent tooth. The prevalence rates were higher in females as compared to the males (3:2, respectively). The association of hypodontia with other systemic conditions and dental anomalies is widely reported. Recent developments in molecular genetics have established the importance of the muscle specific homeobox genes (MSX1 AND MSX2) in dental development. Specific genes that are responsible for the more severe types of hypodontia, including ectodermal dysplasia, have been identified by linkage analysis. However, a variable expression of the trait suggests a polygenic mode of inheritance with the interaction of epistatic genes and environmental factors.

Idiopathic oligodontia (8) of the primary dentition is very rare. A case was reported of a 2 year and 6 month old boy, who presented with fourteen missing primary teeth. Tooth agenesis (9) may originate from either genetic or environmental factors. Genetically determined hypodontic disorders appear as isolated features or as part of a syndrome. MSX1, PAX9, AND AXIN2 are involved in non-syndromic hypodontia, while genes such as SHH, PITX2, IRF6, AND P63 are considered to participate in syndromic genetic disorders, which include tooth agenesis. In dentistry, artificial tooth implants represent a common solution to tooth loss problems; however, molecular dentistry offers promising solutions for the future.
Anomalies of tooth number (10) may not be isolated conditions, but may have wider associations in the development of the dentition, including tooth size. This study was aimed to examine the links between hypodontia, supernumerary teeth and crown size, considering the effect on the development of the whole dentition and to increase the understanding of the aetiology of these conditions. Further, it has shown that the greater the number of the missing teeth, the smaller the tooth size. The hypodontia patients also showed higher variability in tooth dimensions than that found in the control group. Patients with supernumerary teeth had larger teeth than seen in the controls, with the greatest differences in the mesiodistal dimensions. In patients both hypodontia and supernumerary conditions, the differences in tooth size were generalized throughout the dentition. In anomalies of tooth number, the size of the teeth was also involved. In patients with hypodontia and supernumerary teeth conditions, the crown size of the whole dentition was affected. These findings are compatible with a multifactorial aetiology of these conditions.
Numerous epidemiological studies (11) of hypodontia have shown the distributions of hypodontia in an adolescent sample of American blacks with a comparable sample of whites. The prevalence of people with missing teeth is significantly lower in blacks than in whites, as is the number of missing teeth per person. Significant sex differences were found only for the third molars (absence more common in females), and the sex differences were greater in whites than in blacks.
The congenital absence of teeth is a complex condition (12) affecting several parameters of oral development. This was the first study which was done to measure tooth crown dimensions by using image analysis in a family with hypodontia, in whom the mutation was identified, and to compare them with a control group. The majority of tooth types throughout the dentition were significantly smaller in the family members with hypodontia than in the control group, for all parameters which were measured. The significantly smaller tooth crown dimensions which were recorded in the affected family members showed that the effect of the PAX9 mutation was seen not only in the congenitally missing teeth, but also in smaller crown sizes throughout the dentition.
The developmental (13) absence of teeth (hypodontia) was reported to be associated with characteristic morphological changes in the teeth, alveolar volume deficiencies, and skeletal jaw malrelationships. The reports (14) on the management of the patient with oligodontia by using adhesive techniques and new restorative materials, represent the current options in the management of the dental rehabilitation of young patients with oligodontia.
In familial human hypodontia (15), the congenital absence of teeth is one of the commonest developmental abnormalities which are seen in human populations. Familial hypodontia or oligodontia represents an absence of the varying numbers of primary and/or secondary teeth as an isolated trait. While much progress has been made in understanding the developmental basis of tooth formation, the knowledge on the aetiological basis of the inherited tooth loss remains poor. The study of mouse genetics has uncovered a large number of candidate genes for this condition, but mutations in only three have been identified in human pedigrees with familial hypodontia or oligodontia: MSX1, PAX9 AND AXIN2. This suggests that these conditions may represent a more complex multifactorial trait, influenced by a combination of gene functions, environmental interactions and developmental timing. Completion of the human genome project has made available the DNA sequence of the collected human chromosomes, thus allowing the localization of all human genes and, ultimately, the determination of their functions.

Treatment
Management1 of missing teeth, abnormal occlusion, or altered facial appearance may cause psychological distress in some patients. If the extent of hypodontia is mild, the associated changes may likewise be slight and manageable by orthodontics. In more severe cases, restorative implants and prosthetic procedures can be undertaken.

The management may be complex (13), involving several dental specialties, and requires that they ideally work as a close-knit team. Improved diagnostic and treatment technologies continue to evolve, ever widening the management opportunities for these patients.

There are a number of options which are available for the restoration of the space which is generated (14) by the missing teeth. The dental treatment can vary, depending on the severity of the disease and it generally requires a multidisciplinary approach.

Conclusion

Not all the cases need to undergo treatment, unless there is a requirement. Dental clinicians should keep in mind that there are good possibilities with conventional prosthodontic techniques to help patients with severe dental anomalies. The treatment not only improves speech and masticatory function, but also has psychological implications that may greatly help in regaining self-confidence. Specialist teams with access to traditional and evolving diagnostic and treatment technologies are best able to manage patients with complex treatment needs such as some of those presenting with hypodontia. The loss of teeth in young patients can cause aesthetic, functional, and psychological problems, particularly if the teeth of the anterior region are involved. Proper diagnosis can help in the management of these cases in a sportive way. Anyway, our patient did not have any problem which was related to speech, except the lisping of certain words, with which he was not bothered. The patient was motivated because of this and recalled for follow up.

References

1.
R Rajendran,B Sivapathasundharam Editors, Shafer’s A textbook of Oral Pathology, 5th White. The aetiology of hypodontia: the within, Elsevier publication 2007 p64
2.
Parkin N, Elcock C, Smith RN, Griffin RC, Brook prevalence, severity and fa and pharaoh editors, Oral Radiology principles and interpretation, 5th editionp332
3.
edition location of hypodontia AHmilies. Arch Oral Biol. 2008 dec 18. [Epub ahead of print].
4.
Behr M, Driemel O, Mertins V, Gerlach T, Kolbeck C, Rohr N, Reichert TE, Handel G Studied on concepts for the treatment of adolescent patients with missing permanent teeth. Oral Maxillofacial Surg. 2008 Jul; 12(2):49-60.
5.
He X, Shu W, Kang Y, Li Z, Zhang J, Kari K, Meurman JH. Esthetic and functional rehabilitation of a patient with nonsyndromic oligodontia:a case report from china. J Esthet Restor Dent. 2007; 19(3):137-42
6.
Parti. Larmour CJ, Mossey PA, Thind BS, Forgie AH, Stirrups DR, Al-emran S. Prevalence of hypodontia and developmental malformation of permanent teeth in Saudi Arabian schoolchildren. Br J Orthod. 1990 may; 17(2):115-8. )
7.
Parti. Larmour CJ, Mossey PA, Thind BS, Forgie AH, Stirrups DR. Hypodontia- a retrospective review of prevalence and etiology. Quintessence 2005 apr; 36(4):263-70.
8.
Shilpa, Thomas AM, Joshi JL. Idiopathic oligodontia in primary dentitions: case report and review of literature. J Clin Pediatr Dent. 2007 fall; 32(1):65-7.
9.
Matalova E, Fleischmannova J, Sharpe Pt, Tucker AS Tooth agenesi:from molecular genetics to molecular dentistry. J Dent Res. 2008 Jul; 87(7):617-23.
10.
Brook AH, Griffin RC, Smith RN, Townsend GC, Kaur G, Davis GR, Fearne J tooth size patterns in patients with hypodontia and supernumary teeth. Arch oral biol. 2008 aug 1. [Epub ahead of print].)
11.
Harris EF, Clark LL hypodontia: an epidemiologic study of American black and white people Am J Orthod Dentofacial Orthop. 2008 dec; 134(6):761-7.
12.
Brook Ah, Elcock C, Aggarwal M, Lath Dl, Russell JM, Patel Pi, Smith RN. Tooth dimension in hypodontia with a known pax9mutation.Arch Oral Biol. 2008 jul 23.
13.
Nohl F, Cole B, Hobson R, Jepson N, Meechan J, Wright M. The management of hypodontia:present and future. Dent Update. 2008 mar; 35(2):79-80, 82-4, 86-8 passim.
14.
Akkaya N, Kiremitçi A, Kansu O. Treatment of a patient with oligodontia: a case report. J Contemp Dent Pract. 2008 mar 1; 9(3):121-7.
15.
Cobourne MT. Familial human hypodontia- is it all in the genes? Br Dent J. 2007 Aug 25; 203(4):203-8.

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com