Prevalence of Premature Eruption and Agenesis of Premolars in Turkish Children: A Retrospective Study

Objective: To determine the prevalence and distribution of premature eruption and agenesis of premolars in a sample of Turkish children. Study design: A sample of 1715 patients aged 5 to 11 years was selected. Panoramic radiographs were used to assess premature eruption and agenesis of premolars. Developmental stage of erupted premolars was assessed using Demirjian’s method and selecting prematurely erupted premolars on the basis of clinical eruption with a root length less than half of their final expected root lengths. Statistical analysis was performed using chi-square test (p <.05). Results: One hundred fifteen (6.7%) of 1715 patients presented at least one premolar agenesis with no significant sex difference (56 boys, 59 girls). Mandibular second premolars were the most absent teeth. Multiple agenesis of premolars (3.4%) was more common than single agenesis (3.3%). A total of 85 (5.0%) patients (51 boys, 34 girls; no significant sex difference) had at least one prematurely erupted premolar, and maxillary first premolars were most commonly affected. Early erupted premolars were in stage D or E based on Demirjian’s dental formation scale. Conclusions: The prevalence of premature eruption and agenesis of premolars in Turkish children were 5.0% and 6.7%, respectively. Both conditions are not uncommon and may highlight the need for early diagnosis to prevent subsequent clinical problems.

Dental anomalies; Tooth eruption; Panoramic radiography; Tooth agenesis; Premolars

1. Neville BW, Damm DD, Allen CM, Chi AC. Abnormalities of Teeth, in: Oral and Maxillofacial Pathology. 4th Ed. St. Louis, MO: Elsevier Health Sciences; 49-110, 2015.

2. Larmour CJ, Mossey PA, Thind BS, Forgie AH, Stirrups DA. Hypodonhia— A retrospective review of prevalence and etiology. Part I. Quintessence Int; 36(4):263-270. 2005.

3. Choi SJ, Lee JW, Song JH. Dental anomaly patterns associated with tooth agenesis. Acta Odontol Scand; 75(3):161-5. 2017.

4. Massler M, Schour I. Studies in tooth development: Theories of eruption. Am J Orthod Dentofacial Orthop; 27(10):552-576. 1941.

5. Marks SC, Jr., Schroeder HE. Tooth eruption: theories and facts. Anat Rec; 245(2):374-393. 1996.

6. Marks SC, Jr., Cahill DR. Experimental study in the dog of the non-active role of the tooth in the eruptive process. Arch Oral Biol; 29(4):311-322. 1984.

7. Gowgiel JM. Eruption of irradiation-produced rootless teeth in monkeys. J Dent Res; 40(3):538-547. 1961.

8. Brin I, Zilberman Y, Galili D, Fuks A. Eruption of rootless teeth in congenital renal disease. Oral Surg Oral Med Oral Pathol; 60(1):61-4. 1984.

9. Cho VYY, Anthonappa RP, King NM. Unusual sequelae of a subluxated primary incisor on its permanent successor tooth. Dent Traumatol; 35(1):80-4. 2019

10. Shapira Y, Kuftinec MM. Rootless eruption of a mandibular permanent canine. Am J Orthod Dentofacial Orthop; 139(4):563-6. 2011.

11. Catala M, Zaragoza A, Estrela F, Valdemoro C. Unusual case of rootless premolar. Pediatr Dent; 17(2):127-8. 1995.

12. Fanning EA. Effect Of Extraction Of Deciduous Molars On The Formation And Eruption Of Their Successors. Angle Orthod; 32(1):44-53. 1962.

13. Gron AM. Prediction of tooth emergence. J Dent Res; 41:573-585. 1962.

14. Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol; 45(2):211-227. 1973.

15. Becker A. Orthodontic Treatment of Impacted Teeth. 3rd ed. West Sussex, UK: Wiley-Blackwell; 5, 2012.

16. Brin I, Koyoumdijsky-Kaye E. The influence of premature extractions of primary molars on the ultimate root length of their permanent successors. J Dent Res; 60(6):962-5. 1981.

17. Wedl JS, Schoder V, Blake FA, Schmelzle R, Friedrich RE. Eruption times of permanent teeth in teenage boys and girls in Izmir (Turkey). J Clin Forensic Med; 11(6):299-302. 2004.

18. Posen AL. The effect of premature loss of deciduous molars on premolar eruption. Angle Orthod; 35:249-252. 1965.

19. Sleichter G. The influence of premature loss of deciduous molars and the eruption of their successors. Angle Orthod; 33(4):279-283. 1963.

20. Demiriz L, Hazar Bodrumlu E. Reasons for the Extraction of Primary Teeth in Primary School-age Children in Zonguldak, Turkey: A Retrospective Study. Meandros Med Dent J; 19:32-8. 2018.

21. Eroğlu CN, Boylu ÖF, Kurt M, Elasan S. Surgical Evaluation of The Early Extraction of Deciduous Teeth by Faculty of Dentistry Oral and Maxillofacial Surgery Clinic Throughout A Year: Retrospective Study. Eastern J Med; 23(3):182-6. 2018.

22. Altug-Atac AT, Erdem D. Prevalence and distribution of dental anomalies in orthodontic patients. Am J Orthod Dentofacial Orthop; 131(4):510-4. 2007.

23. Lagana G, Venza N, Borzabadi-Farahani A, Fabi F, Danesi C, Cozza P. Dental anomalies: prevalence and associations between them in a large sample of non-orthodontic subjects, a cross-sectional study. BMC Oral Health; 17(1):62. 2017.

24. Hagiwara Y, Uehara T, Narita T, Tsutsumi H, Nakabayashi S, Araki M. Prevalence and distribution of anomalies of permanent dentition in 9584 Japanese high school students. Odontology; 104(3):380-389. 2016.

25. Uslu O, Akcam MO, Evirgen S, Cebeci I. Prevalence of dental anomalies in various malocclusions. Am J Orthod Dentofacial Orthop; 135(3):328- 335. 2009.

26. Polder BJ, Van’t Hof MA, Van der Linden FP, Kuijpers‐Jagtman AM. A meta‐analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol; 32(3):217-226. 2004.

27. Kazanci F, Celikoglu M, Miloglu O, Ceylan I, Kamak H. Frequency and distribution of developmental anomalies in the permanent teeth of a Turkish orthodontic patient population. J Dent Sci; 6(2):82-9. 2011.

28. Shalish M, Peck S, Wasserstein A, Peck L. Malposition of unerupted mandibular second premolar associated with agenesis of its antimere. Am J Orthod Dentofacial Orthop; 121(1):53-6. 2002.

29. Gelbrich B, Hirsch A, Dannhauer K-H, Gelbrich G. Agenesis of second premolars and delayed dental maturation. J Orofac Orthop; 76(4):338- 350. 2015.

30. Navarro J, Cavaller M, Luque E, Tobella ML, Rivera A. Dental anomaly pattern (DAP): agenesis of mandibular second premolar, distal angulation of its antimere and delayed tooth formation. Angle Orthod; 84(1):24-9. 2014.