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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 4  |  Issue : 2  |  Page : 60-64

Association between immobile over-retained primary incisors, diet consistency, and the presence of crowding


1 Department of Pedodontics and Preventive Dentistry, Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamil Nadu, India
2 Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
3 Department of Oral Pathology, Vinayaka Mission's Sankarachariyar Dental College, Salem, Tamil Nadu, India
4 Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India

Date of Submission08-Nov-2019
Date of Decision24-Mar-2019
Date of Acceptance30-Mar-2019
Date of Web Publication29-Nov-2019

Correspondence Address:
Paul Chalakkal
Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim - 403 202, Goa
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpr.ijpr_26_18

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  Abstract 


Context: Immobile over-retained primary teeth often deflect the path of eruption of their corresponding permanent teeth, resulting in ectopic eruption. Although various etiologies have been mentioned in literature, there is little regarding its association with consistency of diet and the presence of crowding. Aim: This study was undertaken to evaluate the association between the presence of immobile over-retained primary incisors (IOPIs), the consistency of foods consumed, and the presence of crowding. Materials and Methods: A total of 101 children with IOPI were randomly selected for evaluation. The consistency (soft, medium, or hard) of the foods consumed by each child during the day was assessed. The presence of crowding in the arches, the number of IOPI present, and the length of the root of each IOPI following its extraction were also assessed. Statistical Analysis: It was carried out using the SPSS software (version 11.5, IBM Corporation, Armonk, New York, USA). The Chi-square test and the Z test were used. Results and Conclusion: No significant association was found between IOPI, the consistency of foods consumed, and the presence of crowding.

Keywords: Food consistency, retained roots, retained teeth


How to cite this article:
Krishnan R, Chalakkal P, Ramesh M, De Souza N, de Ataide Id, Pavaskar R. Association between immobile over-retained primary incisors, diet consistency, and the presence of crowding. Int J Pedod Rehabil 2019;4:60-4

How to cite this URL:
Krishnan R, Chalakkal P, Ramesh M, De Souza N, de Ataide Id, Pavaskar R. Association between immobile over-retained primary incisors, diet consistency, and the presence of crowding. Int J Pedod Rehabil [serial online] 2019 [cited 2019 Dec 6];4:60-4. Available from: http://www.ijpedor.org/text.asp?2019/4/2/60/272063




  Introduction Top


In literature, various factors have been mentioned that result in physiologic primary root resorption (PPRR). The pressure exerted by a succedaneous tooth through its pericoronal follicle (rich in epithelial growth factor) is the most important factor in the differentiation of odontoclasts to result in PPRR.[1],[2] In a study on rabbit teeth, it was found that the dental follicle might play the role of recruitment, development, and activation of odontoclasts.[3] The cytokines and transcription factors in the stellate reticulum and permanent tooth follicle are also known to result in PPRR.[4] However, PPRR has also been reported to occur independently of the eruptional processes of succeeding teeth.[5] The only study in literature that evaluated the relation between occlusal force and PPRR was done on Beagle dogs. It was found that when succedaneous teeth were present, PPRR occurred irrespective of whether occlusal forces were normal or decreased. When occlusal forces were decreased, delay in resorption was observed.[6] However, it has also been mentioned that the resultant trauma to periodontal ligament fibers due to increased masticatory forces may result in PPRR.[7] This cross-sectional study was undertaken to evaluate the association between the presence of immobile over-retained primary incisors (IOPIs), the consistency of foods consumed and the presence of crowding. The research hypothesis assumed was that the consistency of diet and the presence of crowding affected the presence of IOPI.


  Materials and Methods Top


A total of 101 children with IOPI who had visited the department of pedodontics were selected for evaluation irrespective of their age. A primary incisor was considered “over-retained” only if it was present along with its corresponding succedaneous incisor after its eruption. The judgmental sampling method was used, and the sample size was calculated using the formula:



Where, Z = Z value (2.58 for 99% confidence and 1.96 for 95% confidence level); p = percentage picking a choice (0.5 used for sample size needed) and; c = confidence interval (0.05). The new sample size (corrected for a finite population) was calculated using the formula:



Where, N = population. Each child was handed over a questionnaire which included the following questions that needed to be answered by either of the child's parents or the guardian if the child was not living with his/her parents: name, age, and sex, and list of foods consumed for breakfast, lunch, dinner, and snack. The answers were again recorded by a single examiner after they were compared with a reference sheet which contained names of all conventional foods that may be consumed for breakfast, lunch, dinner, or snack and the consistency (soft, medium. or hard) of each of the foods. Clinical examination was also made and the following were recorded: number of IOPI present in the maxillary and mandibular arches, length of the root of each IOPI following its extraction, and the presence of crowding in relation to each IOPI. Statistical analysis was carried out using the SPSS software (version 11.5, IBM Corporation, Armonk, New York, USA). The Chi-square test and the Z test were used. The assessment of IOPI and associated factors in 101 children was completed over a period of 1 month.


  Results Top


Of a total 101 children who constituted the study sample, 58 were males and 43 were females. None of the children had 3 IOPI in the maxillary arch (1, 2, or 4 IOPI only). However, the number of mandibular IOPI varied from one to four in each child. No significant associations were found between the consistency of foods consumed during breakfast [Table 1], lunch [Table 2], dinner [Table 3], or snack [Table 4] and the presence of IOPI in the maxillary arch. Similarly, no significant associations were found between the consistency of foods consumed during breakfast [Table 5], lunch [Table 6], dinner [Table 7], or snack [Table 8] and the presence of IOPI in the mandibular arch. No significant associations were found between crowding and the presence of IOPI in the maxillary [Table 9] or mandibular [Table 10] arches. Moreover, no significant associations were found between the extent of root resorption on IOPI and their presence in the maxillary [Table 11] or mandibular [Table 12] arches.
Table 1: Association between maxillary immobile over-retained primary incisor and the consistency of foods consumed for breakfast

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Table 2: Association between maxillary immobile over-retained primary incisor and the consistency of foods consumed for lunch

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Table 3: Association between maxillary immobile over-retained primary incisor and the consistency of foods consumed for dinner

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Table 4: Association between maxillary immobile over-retained primary incisor and the consistency of snacks consumed

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Table 5: Association between mandibular immobile over-retained primary incisor and the consistency of foods consumed for breakfast

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Table 6: Association between mandibular immobile over-retained primary incisor and the consistency of foods consumed for lunch

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Table 7: Association between mandibular immobile over-retained primary incisor and the consistency of foods consumed for dinner

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Table 8: Association between mandibular immobile over-retained primary incisor and the consistency of snacks consumed

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Table 9: Association between maxillary immobile over-retained primary incisor and the presence of crowding

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Table 10: Association between mandibular immobile over-retained primary incisor and the presence of crowding

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Table 11: Extent of root resorption in extracted maxillary immobile over-retained primary incisor

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Table 12: Extent of root resorption in extracted mandibular immobile over-retained primary incisor

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  Discussion Top


Apart from the permanent tooth follicle, the formation of odontoclasts may also be from pulpal cytokine-producing cells that mediate the monocyte–macrophage lineage.[8] Odontoclasts express cathepsin K mRNA[9] and matrix metalloproteinase-9 (MMP-9),[10] which may participate in proteolysis, leading to PPRR. H+-ATPase mediates the active extrusion of proton ions, resulting in odontoclastic decalcification of apatite crystals.[11] Odontoclasts have been found to express MT1-MMP (Membrane type 1-MMP) mRNA.[12] Odontoclasts and its surrounding areas have also been found to contain extracellular matrix proteins such as bone sialoprotein and osteopontin.[13] The role of stem cells from human exfoliated deciduous teeth has been suggested in PPRR, due to its osteoclastic and osteogenic potentials.[14],[15] Apoptosis induced by cementoblasts, which reveals the mineralized portion of the root while attracting odontoclasts, has also been suggested as the cause for PPRR.[1],[16] Proteoglycans such as biglycan and decorin may also lead to PPRR.[17] Receptor activator of NF-kappaB ligand (RANKL), that is probably produced by mononuclear stromal cells and odontoclasts, is expressed by periodontal ligament cells and may participate in odontoclastogenesis.[4],[8],[11],[18],[19] Moreover, the gene Runx2 upregulates RANKL and downregulates OPG, in periodontal ligament stem cells, leading to PPRR.[20] There has been no previous study in literature that has assessed the relation between diet consistency, crowding, and the presence of IOPI in humans. The clinical implication of this study is the finding that diet consistency or the presence of crowding does not affect the occurrence of IOPI. However, the occurrence of IOPI may be attributed to misalignment in the path of eruption of their corresponding succedaneous teeth, especially in the case of primary molars with divergent roots.[7] The extent of root resorption was calculated by comparing the length of the root of each IOPI with the standard root length of those teeth.[21] The study contained certain limitations in assessment. The consistency of the food items consumed daily was assessed; however, the quantity of foods consumed by each child could not be assessed. Although the consistency of each meal was recorded as either soft, medium, or hard, it could have been possible that certain children would have consumed a mixture of hard, medium, and soft foods in a single meal. A diet diary was not provided for recording the foods consumed over a period of time since it was a cross-sectional study. The foods shared between friends which could have differed in consistency, were not taken into account in this study. Moreover, the frequency of snacking could have also varied from child to child. Future studies may be conducted to assess the association between the frequency or quantity of diet and the presence of IOPI.


  Conclusion Top


No association was found between consistency of foods consumed, presence of crowding, and the occurrence of IOPI.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Consolaro A. Orthodontic movement in deciduous teeth. Dental Press J Orthod 2015;20:16-9.  Back to cited text no. 1
    
2.
Francini E, Mancini G, Vichi M, Tollaro I, Romagnoli P. Microscopical aspects of root resorption of human deciduous teeth. Ital J Anat Embryol 1992;97:189-201.  Back to cited text no. 2
    
3.
Sahara N. Cellular events at the onset of physiological root resorption in rabbit deciduous teeth. Anat Rec 2001;264:387-96.  Back to cited text no. 3
    
4.
Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: Molecular and histological events. J Oral Sci 2007;49:1-2.  Back to cited text no. 4
    
5.
Bille ML, Nolting D, Kvetny MJ, Kjaer I. Unexpected early apical resorption of primary molars and canines. Eur Arch Paediatr Dent 2007;8:144-9.  Back to cited text no. 5
    
6.
Ishikura Y. A study of root resorption of deciduous teeth in dogs. Influence of successional tooth germ and occlusal force. Shoni Shikagaku Zasshi 1991;29:102-29.  Back to cited text no. 6
    
7.
Marwah N, Tooth eruption and shedding In: Marwah N (editor) Textbook of Pediatric Dentistry. 3rd ed. Jaypee Brothers Medical Publishers (P) Ltd New Delhi 2014. p. 145-55.  Back to cited text no. 7
    
8.
Yildirim S, Yapar M, Sermet U, Sener K, Kubar A. The role of dental pulp cells in resorption of deciduous teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:113-20.  Back to cited text no. 8
    
9.
Linsuwanont B, Takagi Y, Ohya K, Shimokawa H. Localization of cathepsin K in bovine odontoclasts during deciduous tooth resorption. Calcif Tissue Int 2002;70:127-33.  Back to cited text no. 9
    
10.
Linsuwanont B, Takagi Y, Ohya K, Shimokawa H. Expression of matrix metalloproteinase-9 mRNA and protein during deciduous tooth resorption in bovine odontoclasts. Bone 2002;31:472-8.  Back to cited text no. 10
    
11.
Oshiro T, Shibasaki Y, Martin TJ, Sasaki T. Immunolocalization of vacuolar-type H+-ATPase, cathepsin K, matrix metalloproteinase-9, and receptor activator of NFkappaB ligand in odontoclasts during physiological root resorption of human deciduous teeth. Anat Rec 2001;264:305-11.  Back to cited text no. 11
    
12.
Linsuwanont-Santiwong B, Takagi Y, Ohya K, Shimokawa H. Expression of MT1-MMP during deciduous tooth resorption in odontoclasts. J Bone Miner Metab 2006;24:447-53.  Back to cited text no. 12
    
13.
Lee A, Schneider G, Finkelstein M, Southard T. Root resorption: The possible role of extracellular matrix proteins. Am J Orthod Dentofacial Orthop 2004;126:173-7.  Back to cited text no. 13
    
14.
Lu BW, Liu N, Xu LL, Shi HG, Zhang Y, Zhang W. Difference of in vitro osteogenic differentiation and osteoclast capacity between stem cells from human exfoliated deciduous teeth and dental pulp stem cells. Nan Fang Yi Ke Da Xue Xue Bao 2016;36:180-5.  Back to cited text no. 14
    
15.
Zhu Y, Shang L, Chen X, Kong X, Liu N, Bai Y, et al. Deciduous dental pulp stem cells are involved in osteoclastogenesis during physiologic root resorption. J Cell Physiol 2013;228:207-15.  Back to cited text no. 15
    
16.
Domon T, Taniguchi Y, Inoue K, Ushijima N, Taishi Y, Hiramatsu A, et al. Apoptosis of odontoclasts under physiological root resorption of human deciduous teeth. Cell Tissue Res 2008;331:423-33.  Back to cited text no. 16
    
17.
Benedetto MS, Siqueira FM, Mascaro MB, Araújo VC, Bönecker MJ. Immunohistochemical expression of biglycan and decorin in the pulp tissue of human primary teeth during resorption. Braz Oral Res 2013;27:438-44.  Back to cited text no. 17
    
18.
Lin BC, Zhao YM, Yang J, Ge LH. Root resorption of primary molars without successor teeth. An experimental study in the beagle dog. Eur J Oral Sci 2012;120:147-52.  Back to cited text no. 18
    
19.
Fukushima H, Kajiya H, Takada K, Okamoto F, Okabe K. Expression and role of RANKL in periodontal ligament cells during physiological root-resorption in human deciduous teeth. Eur J Oral Sci 2003;111:346-52.  Back to cited text no. 19
    
20.
Li B, Zhang Y, Wang Q, Dong Z, Shang L, Wu L, et al. Periodontal ligament stem cells modulate root resorption of human primary teeth via Runx2 regulating RANKL/OPG system. Stem Cells Dev 2014;23:2524-34.  Back to cited text no. 20
    
21.
Nelson SJ, Ash MM, editors. The primary (deciduous) teeth. In: Wheeler's Dental Anatomy, Physiology and Occlusion. St. Louis, Missouri: Elsevier; 2010. p. 45-66.  Back to cited text no. 21
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12]



 

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