Prevalence and Distribution of Selected Dental Anomalies in the Patients Reporting to Dental Institute, RIMS, Ranchi.

AIM: The purpose of this study was to determine the prevalence of developmental dental anomalies in the East Indian subpopulation.
MATERIALS AND METHODS: The study was based on clinical examination, evaluation of dental casts, and radiographs of 2385 Indian patients (1169 males and 1216 females), who visited Dental Institute, Rajendra Institute of Medical Sciences, Ranchi. These patients were examined for shape anomalies, number anomalies, structural anomalies, and positional anomalies.
RESULTS: It was observed that 5.83% of patients reported with a dental anomaly. Males reported with higher incidence with a male-to-female ratio of 1: 0.96. Microdontia was the most common anomaly. Unilateral microdontia was more common than bilateral and was more prominent in males (9.05%). It was observed that peg laterals were frequently encountered developmental anomaly at 1.34%, while the incidence of amelogenesis imperfecta and dentinogenesis imperfecta was 0.29% and 0.33%, respectively. The present demography reported a very low incidence of dens, fusion, hyperdontia, hypodontia, and macrodontia at <0.01%, whereas anomalies such as transportation, transmigration, and hypodontia of the maxillary molar reported no prevalence.
CONCLUSION: The percentage of dental anomalies although low should be treated as soon as possible to avoid further complications. The results of our study can serve as an indicator to ascertain the pattern of dental anomalies in Jharkhand. This might help to plan the dental treatment of the community. Copyright:

INTRODUCTION

Dental anomalies are a common occurrence in patients which can be due to disturbances during tooth formation. These anomalies seem to have an effect on the size, shape, color, and number of teeth. These can be of different types such as developmental, congenital, or acquired and may be localized to single tooth or involving multiple teeth due to some systemic conditions.[1] As per Sarnat and Schour,[2] the developing tooth provides a definite record of variations in the tooth development and its mineralization. Although they have a low frequency of occurrence in comparison to other disorders such as dental caries and periodontal diseases, the management of dental anomalies is more complicated, as they have a direct implication on the occlusion and esthetics of the patient predisposing to other oral problems.[3]

Many epidemiological surveys have been conducted in different parts of the world to determine the prevalence of various types of dental anomalies.[456789101112131415161718192021] However, very few studies have been conducted to ascertain the pattern and types of dental anomalies in India.

Hence, the aim of the present study is to evaluate the types of dental anomalies in the patients reporting to Dental Institute, RIMS, Ranchi, as this longitudinal epidemiological survey would increase the insight in the prevalence of dental anomalies. This study can be a new contribution to the literature.

MATERIALS AND METHODS

The study was conducted in the department of conservative, endodontics, and esthetic dentistry, Dental Institute, RIMS, Ranchi, after obtaining permission from the Institutional Ethical Committee. Two thousand and three hundred and eighty-five patients aged between 15 and 60 years (1216 females and 1169 males) were included in the study after seeking an informed consent from them.

Each patient was examined clinically for dental anomalies using dental mirror in the presence of sufficient light. The clinical and demographic details of the patient and the number, size, and shape of the dentition were carefully checked, and all the abnormalities were recorded. The panoramic views of these patients were also carefully analyzed. Radiograph (Intraoral Periapical Radiograph or Orthopantamogram) was advised wherever required. The patients were examined for the following anomalies: These patients were examined for the following developmental dental anomalies: shape anomalies (microdontia, talon cusp, dens evaginatus, fusion, taurodontism, and peg laterals), number anomalies (hypodontia and hyperdontia), structural anomalies (amelogenesis imperfecta and dentinogenesis imperfecta), and positional anomalies (ectopic, transportation, and transmigration). The criteria followed for the assessment of anomalies were similar to the one employed by Gupta et al.[17]

Data analysis

The 1BMR SPSSR Software was used for data analysis. Values were compared using Student's t-test. P < 0.05 considered with 95% confidence interval in the study considered as statistically significant.

RESULTS

The present study was conducted to ascertain the prevalence of selected dental anomalies in patients reporting to Dental Institute, Rajendra Institute of Medical Sciences, Ranchi. The distribution and prevalence of developmental dental anomalies in a study group of 2385 individuals are elaborated in Table 1.

Table 1

Distribution and prevalence of developmental dental anomalies in a study group of 2385 individuals

Dental anomalies	Female (n=1216)	Male (n=1169)	Total (n=2385)	Mean±SD	SEM	t-test	P
Unilateral microdontia	7	99	106	2.06±3.1	0.65	3.181	0.004 (S)
Bilateral microdontia	11	13	24				0.13 (NS)
Unilateral talon cusps	1	1	2				0.32 (NS)
Bilateral talon cusps	1	3	4				0.11 (NS)
Unilateral dens evaginatus	1	1	2				0.06 (NS)
Bilateral dens evaginatus	1	3	4				0.43 (NS)
Unilateral fusion	1	1	2				0.31 (NS)
Bilateral fusion	0	1	1				0.12 (NS)
Unilateral peg lateral	2	4	6				0.41 (NS)
Bilateral peg lateral	11	15	26				0.32 (NS)
Hypodontia maxillary central incisor	0	0	0				0
Hypodontia maxillary lateral incisor	1	0	1				0.12 (NS)
Hypodontia mandibular central incisor	0	0	0				0
Hypodontia maxillary premolar	0	2	2				0.41 (NS)
Hypodontia mandibular premolar	1	1	2				0.12 (NS)
Hypodontia maxillary molar	0	0	0				0
Hypodontia mandibular molar	1	0	1				0.12 (NS)
Hyperdontia maxillary unilateral	2	4	6				0.13 (NS)
Hyperdontia maxillary bilateral	1	2	3				0.32 (NS)
Hyperdontia mandibular unilateral	1	3	4				0.11 (NS)
Hyperdontia mandibular bilateral	1	2	3				0.13 (NS)
Amelogenesis imperfecta	2	5	7				0.22 (NS)
Dentinogenesis imperfecta	2	6	8				0.04 (S)
Transposition unilateral	0	0	0				0
Transposition bilateral	0	0	0				0
Transmigration unilateral	0	0	0				0
Transmigration bilateral	0	0	0				0
Macrodontia unilateral	1	2	3				0.11 (NS)
Macrodontia bilateral	4	5	9				0.13 (NS)

SD: Standard deviation, SEM: Standard error of mean, S: Significant, NS: Not significant

Student's t-test (t = 3.181) was used to compare the mean difference of the dental anomalies between males and females. Statistically, no significant difference was found between males and females with respect to dental anomalies. However, statistical significant difference was found with unilateral microdontia (P = 0.004) and dentinogenesis imperfect (P = 0.04). It implies that there is a significant difference in unilateral microdontia and amelogenesis imperfect on intragroup comparison. Therefore, the prevalence of unilateral microdontia and amelogenesis imperfecta is statistically comparable among males and females.

It was observed that only 5.83% of the total patients presented with an anomaly, while only 1.27% presented with two anomalies whereas none of the patients presented with more than two anomalies. Hence, it can be also concluded that the incidence of dental anomalies is low in this demography.

DISCUSSION

Although many researchers have studied the prevalence of dental anomalies, only limited studies have analyzed the prevalence and distribution of various developmental dental anomalies in the Indian population. There was a significant difference between the prevalence of dental anomalies observed in previous epidemiological studies and the present study.

In the present study, 2385 patients between the age of 15–60 years were examined for anomalies. About 5.83% of patients (n = 139) reported with a dental anomaly contrary to the findings of Gupta et al.[17] who in their study conducted in Indore, India, observed that 31.26% of patients in their study presented with an anomaly. In our study, 109 patientss (4.55%) reported with one anomaly, whereas 1.27% of patients (30) had two anomalies. None of the patients had more than two anomalies. To the best of the knowledge of the authors, it is the only study where such a large number of sample size was evaluated. Males had a greater incidence of anomaly with male-to-female ratio of 1:0.96.

It was observed in our study that microdontia was the most common anomaly (5.44%). Unilateral microdontia was more common than bilateral at 4.44% and 1.006%, respectively, and was more prominent in males (9.05%). Our results were similar to the works of Tsai and King,[19] Thongudomporn and Freer,[10] and Guttal et al.[21] who evaluated South Chinese and Saudi Arabian population and reported an incidence of 6.9%, 9.9%, and 5.8%. In India, Guttal et al.[21] and Gupta et al.[17] conducted similar studies and reported the prevalence of microdontia at 0.16% and 2.58%, respectively. Gupta et al. reported microdontia as the most prevalent anomaly in their study as was observed in our study.

Our study reported that peg laterals as another commonly occurring developmental anomaly at 1.34%. Its bilateral occurrence was more common with 26 of the 2385 patients being affected with it. Like microdontia, peg lateral was more common in males, Proffit[22] mentioned peg laterals as the most common abnormality is variation in size, particularly in the maxillary lateral incisors with a prevalence range from 0.8% to 8.4% in various populations. The result of Proffit[22] correlates well with the study.

Our study reported the incidence of amelogenesis imperfecta and dentinogenesis imperfecta at 0.29% and 0.33%, respectively. Studies conducted by Thongudomporn and Freer,[10] Uslu et al.,[23] Ghaznawi,[20] Ezoddini et al.,[24] Bäckman and Wahlin,[25] and Guttal et al.[21] reported of no incidence. Altug-Atac and Erdem[26] reported that, among the Turkish population, amelogenesis imperfecta had a total prevalence of 0.43% and that was the third most common developmental dental anomaly among that population. Gupta et al.[17] reported the prevalence of amelogenesis imperfecta at 0.27% and dentinogenesis imperfecta at 0.09% which made dentinogenesis imperfecta the rarest among that population. The present study reported a very low incidence of dens, fusion, hyperdontia, hypodontia, and macrodontia at <0.01%, whereas anomalies such as transportation, transmigration, and hypodontia of the maxillary molar reported no prevalence. Guttal KS[21] and Gupta et al.[17] also reported a low incidence of such anomalies in the Indian population, whereas Altug-Atac and Erdem[26] and Uslu et al.[23] in Turkish population and Bäckman and Wahlin[25] in Swedish population reported a prevalence of 2.63%, 2.16%, and 8.4%.

Conflicting results from other studies might be attributed to racial differences or differences in diagnostic criteria.

CONCLUSION

Within the limitations of our study, the following conclusions can be drawn:

Contrary to the available, Jharkhand reported with a low incidence of dental anomalies

About 5.83% of the sample patients presented with a dental anomaly

Males reported with higher incidence with male-to-female ratio 1:0.96

Incidence of microdontia was higher in this demographic location

Prevalence of dentinogenesis imperfecta and amelogenesis imperfecta was less

Statistical analysis indicated that dental anomalies were independent of sex.

The results of our study can serve as an indicator to ascertain the pattern of dental anomalies in Jharkhand. This might help to plan the dental treatment for the community. In this survey, the prevalence rate of the commonly occurring dental abnormalities was assessed, and it was observed that the prevalence of these abnormalities is quite low compared to other common oral and dental diseases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.