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Objectives: To explore the association between third molar agenesis and supernumerary tooth formation in a white-European population., Materials and Methods: A record review in various orthodontic clinics identified 380 eligible white-European individuals, half of whom had non-syndromic permanent supernumerary teeth (122 males and 68 females, totalling 244 supernumerary teeth; median age: 13.1, iqr: 1.5 years), and the other half were age- and sex-matched controls with full dentition, excluding the third molars. Tooth sequences were identified in panoramic radiographs., Results: In the supernumerary group, approximately 80% of the individuals had a single supernumerary tooth, followed by those having two additional teeth. In both groups, there was no sexual dimorphism in third molar agenesis severity. The prevalence of third molar agenesis in the supernumerary group was similar to that of the control group (28/190 = 14.7% in both groups; p = 1.0). In total, 53 third molars were missing in the supernumerary group (n = 190) compared to 67 in the control group (n = 190; p = .862). The ratio of bilateral to unilateral third molar agenesis was significantly lower in the supernumerary group than in the control group (1.0 vs. 3.7, respectively; p = .026)., Conclusion: The presence of supernumerary teeth did not significantly alter the likelihood of third molar agenesis or its severity. Bilateral third molar agenesis was considerably less prevalent in individuals with supernumerary teeth compared to controls. The present novel findings have important clinical and developmental implications., (© 2024 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

Traditionally, dental identification techniques are used to establish identity or assist in reconstructing an individual's biological profile. However, other aspects of identity, namely socioeconomic status (SES), can be estimated through teeth. This work aims to evaluate the influence of SES on third molar agenesis in a Portuguese population. X-rays from 448 subjects (223 belonging to a high and 225 to a low socioeconomic status) were assessed and demographic data (age, sex) and dental history were registered. Frequencies and associations between the variables were analyzed using the chi-square test. For each group, differences between third molar agenesis were studied using the Wilcoxon test. The significance level was 5%. X-rays displaying at least one agenesis were more common in females (in both SES groups). Differences between socioeconomic status were found in female subjects' upper right and lower left third molars, with a higher frequency of agenesis in the lower SES group. Agenesis of lower third molars displayed fluctuant asymmetry in both groups, whereas agenesis of upper third molars was also present in the lower SES group. These results suggest that socioeconomic status can affect third molar agenesis prevalence, and fluctuant asymmetry seems more prevalent in the lower SES, as it affects all third molars., (© 2023. The Author(s).)

Purpose: Third molar agenesis (TMA) is the most common craniofacial anomaly and has been associated with craniofacial patterns in different populations. Therefore, the aim of this retrospective cross-sectional study was to assess a possible association between craniofacial patterns and TMA in German orthodontic patients., Methods: Patients undergoing orthodontic treatment with dental records including anamnesis, pretreatment lateral cephalograms and orthopantomograms were evaluated. Cephalometric analyses were conducted digitally and lines, angles and proportions were measured to investigate craniofacial morphology. Skeletal classes were determined by the individualised Wits appraisal and ANB angle. The TMA was identified with the help of orthopantomograms. Patients showing agenesis of at least one third molar were included in the TMA group. Statistical analysis was performed to assess the association between TMA and craniofacial patterns (α of p ≤ 0.05)., Results: A total of 148 patients were included, 40 (27.0%) presented at least one missing tooth (TMA group) and 108 (73.0%) showed full dentition (control group). Skeletal class determined by the individualised Wits appraisal revealed statistical significance between the TMA and control groups (p = 0.022), in which TMA patients were 11 times more likely to present with an individualised skeletal class III (odds ratio 11.3, 95% confidence interval 1.7-139.5). Skeletal cephalometric analysis revealed no statistical differences between TMA and control groups for any further angular, linear and proportional parameters., Conclusion: Third molar agenesis was associated with skeletal class III determined by the individualised Wits appraisal., (© 2023. The Author(s).)

Objectives: The study aimed to examine the authenticity of the often-mentioned statement that the third molar is the most frequently extracted tooth. This finding has not been shown previously in a large population-based sample., Materials and Methods: Data comprised a nationally representative sample of 6082 panoramic radiographs taken from adults in the cross-sectional Health 2000 Survey. From the radiographs, all missing teeth were recorded. Information on congenital agenesis of individual teeth was retrieved from two published meta-analyses. Primary outcome was the frequency of missing teeth by tooth type. Explanatory variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ 2 test and binomial logistic regression., Results: Mean age of participants (46% men, 54% women) was 53 years (SD 14.6; range 30‒97 years). Missing teeth occurred more often in women than in men (P < 0.001). The third molar was most frequently missing and the canine least frequently. In the maxilla and mandible, the third molar was missing more often than each of the other tooth types up to the age of 80 years (P < 0.01)., Conclusions: When considering the rates of congenital agenesis of individual teeth, it is concluded that the third molar remained the most common tooth extracted up till the age of 80 years., Clinical Relevance: The third molar is the most common target for extraction, but also the most common tooth associated with malpractice claims, and therefore, calls for skills, adequate equipment, and other resources for a successful extraction., (© 2024. The Author(s).)

Dental fusion is defined as an abnormality in tooth shape caused by developmental tooth disturbances that produce an intimate union of dental tissues. This case report discusses treatment of a mandibular impacted "double" third molar in a 21-year-old patient that could have been related to either gemination or tooth fusion. Radiological examination allowed for careful analysis of the tooth's shape and root development, relation to the inferior alveolar nerve, and 3-dimensional position. After evaluation of therapeutic options and risks, and with the patient's consent, the authors opted to extract the tooth in question. Such favorable conditions as the incomplete development of the roots and the relatively young age of the patient, combined with the use of an antibiotic and antiseptic prophylaxis as well as a standard surgical approach, enabled a successful result to be achieved with no related complications.

Objective: To investigate the association between the number of third molars and craniofacial shape., Subjects and Methods: The study sample comprised 470 individuals (194 males and 276 females), out of whom 310 (124 males, mean age: 14.6 years and 186 females, mean age: 14.1 years) had a full permanent dentition including third molars and 160 (70 males, mean age: 13.7 years and 90 females, mean age: 13.9 years) had at least one missing third molar. Pre-orthodontic treatment cephalometric images were digitized using 127 landmarks to describe the shape of the entire craniofacial configuration, the cranial base, the maxilla, and the mandible. The shapes of the various configurations were described by principal components (PCs) of shape. The effect of third molar agenesis on craniofacial shape was evaluated with multivariate regression models, considering shape PCs as the dependent variables, and age and sex as predictors., Results: There was a strong association between third molar agenesis and the shape of all craniofacial configurations in both sexes. Individuals with missing third molars presented a less convex craniofacial configuration, a shorter anterior facial height and a more retrusive maxilla and mandible. In cases with third molar agenesis only in one jaw, shape differences were also evident in the opposing jaw., Limitations: Interpretation of study outcomes should take into consideration the two-dimensional data and the analysis of only white-European subjects., Conclusions: There is a strong association between third molar formation and craniofacial shape. The effect is rather generalized than local and is potentially linked to an ongoing evolutionary mechanism that leads to smaller and fewer teeth, as well as smaller craniofacial configurations, in modern humans., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Agenesis of third molar agenesis has a higher incidence than other tooth development anomalies. Previous research identified a potential correlation between third molar agenesis and specific craniofacial morphology; however, no systematic review and meta-analysis on this topic currently exists., Objective: The objective of this systematic review and meta-analysis was to evaluate the association between third molar agenesis and craniofacial sagittal and vertical morphology., Search Methods: An electronic search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library without restrictions on publication year or language; this was supplemented by the manual retrieval of relevant literature., Selection Criteria: Cross-sectional studies that compared craniofacial morphology using angular and linear measurements obtained from lateral cephalography between patients with third molar agenesis and those without were included., Data Collection and Analysis: The quality assessment of the enrolled articles was evaluated by the Joanna Briggs Institute critical appraisal tool. Meta-analysis and sensitivity analysis were performed by Review Manager software (The Cochrane Collaborative, version 5.4, Cochrane IMS)., Results: A total of seven studies were included. Meta-analysis demonstrated that the ANB (mean differences (MD) = -0.75, 95% CI: -1.31 to -0.19, P < 0.01), palate length (ANS-PNS, MD = -1.68, 95% CI: -2.24 to -1.11, P < 0.01), and mandibular length (Go-Pog, MD = -0.36, 95% CI: -0.59 to -0.13, P < 0.01) were smaller in patients with third molar agenesis. With regard to vertical craniofacial morphology, the mandibular plane angle (MP-FH; MD = -1.88, 95% CI: -3.45 to -0.31, P = 0.02), gonial angle (gonial angle; MD = -1.73, 95% CI: -2.69 to -0.77, P < 0.01) and lower face height (lower face heigh angle; MD = -1.36, 95% CI: -1.94 to -0.77, P < 0.01) were smaller in patients with third molar agenesis, indicating a flatter or brachyfacial skeletal pattern., Conclusions: The results of this study suggest that third molar agenesis maybe associated with a reduced maxillary length and a flatter mandible. However, these findings need to be interpreted with caution due to inconsistencies in the certainty of evidence., Clinical Trial Registration: PROSPERO (CRD42023448226)., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Purpose: Third molars (M3s) are the most common congenitally missing teeth. The aim of this study was to compare the frequency of M3 agenesis in two different age groups., Methods: This study examined the panoramic radiographic images of 1036 patients. Two groups, each consisting of 518 patients, were arranged based on age ranges. The patients aged 12 to 19 years were in the first group and those 20 years and older were in the second group. The frequency of M3 agenesis was examined in both age groups. The distribution of M3 agenesis by sex and jaw was also recorded, along with the number of M3s affected by agenesis. Chi-square tests were used to examine the relationships between categorical variables., Results: M3 agenesis was observed in 29.3% and 20.5% in the first and second groups, respectively; the difference was statistically significant (P < .01). It was more common in female (27.3%) than in male patients (21.4%), and in the maxilla (11.2%) than in the mandible (5.8%), and the differences were statistically significant (P < .05). It was mostly observed forthemaxilla right M3 (18) (30.9%) and in the single quadrant of the jaws (9.7%)., Conclusions: The frequency of M3 agenesis was more common in patients aged 12 to 19 years than in those aged 20 years and older. Additionally, M3 agenesis was more common in females and in the maxilla., (© 2020 Wiley Periodicals LLC.)

Background: Tooth agenesis is the congenital lack of one or more primary or permanent teeth and it is the most frequently seen dental anomaly. The prevalence of third molar agenesis is significantly higher than the agenesis of other teeth varying from 10% to 40% and shows geographical variance., Aims: The aim of this study was to investigate the prevalence of third molar agenesis and its association with other tooth agenesis of jaws., Subjects and Methods: A total of 594 Turkish subjects with or without agenesis of third molars (M3) were included in the study. Dental records and panoramic radiographs were evaluated for M3 agenesis, hypodontia and hyperdontia. Significant differences in the prevalence rate of M3 agenesis between genders among with evaluation of coexistence of M3 and other tooth agenesis were determined by Fisher's exact test., Results: The prevalence of M3 agenesis was determined as 28.7% with no statistically significant gender or location difference. Most common form of M3 agenesis involved one molar followed by two, four and three molars. Agenesis of other teeth was seen among both patient groups with and without M3 agenesis, without significant difference., Conclusions: Turkish population with M3 agenesis did not show increased prevalence of other tooth agenesis, indicating no association between occurrence of agenesis of other teeth and M3., Competing Interests: None

Introduction: Tooth agenesis is the most common dental anomaly in humans and is often found in orthodontic patients. However, severe tooth agenesis (oligodontia) is rare and its characteristics are poorly understood. This study aimed to investigate tooth agenesis patterns of Japanese orthodontic patients with nonsyndromic oligodontia., Methods: Panoramic radiographs of 228 orthodontic patients (141 females, 87 males) with nonsyndromic oligodontia were selected and permanent tooth agenesis excluding third molars was evaluated. Influence of cutoff age was tested, tooth agenesis patterns for each quadrant were calculated, and antagonistic maxillary and mandibular quadrants were merged as the occluding tooth agenesis pattern. Full-mouth tooth agenesis patterns were also evaluated., Results: The highest prevalence of tooth agenesis was observed in maxillary and mandibular second premolars, followed by maxillary first premolars. Prevalence of a symmetric pattern between right and left quadrants was significantly higher than matched patterns between maxillary and mandibular antagonistic quadrants. Among 456 possible tooth agenesis patterns, 51 and 49 patterns were observed for the maxillary and mandibular quadrants, respectively, but 215 patterns for the occluding patterns were observed. In addition, 180 full-mouth tooth agenesis patterns were observed in the 228 patients., Conclusions: Distinct characteristics in highly ranked patterns were observed compared with studies from other geographic areas, especially in the maxillary arch. Occluding and full-mouth tooth agenesis patterns showed wide variation, suggesting difficulty in orthodontic diagnosis., (Copyright © 2019 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Racial variation, genetic inheritance and various other factors can affect the jaw size and ultimately the tooth size and number. Studies for agenesis of mandibular third molars have been carried out in various populations but the data relating to these are not evident from most of the parts of Nepal. Hence, the objective of the present study is to determine the prevalence of agenesis of mandibular third molars among the population of patients visiting the Department of Oral Medicine and Radiology of B. P. Koirala Institute of Health Sciences., Methods: This descriptive cross-sectional study was conducted at Department of Oral Medicine And Radiology, College of Dental Surgery, B. P. Koirala Institute of Health Sciences from September 2015 to September 2016 after taking ethical approval from Institutional Review Committee. Two hundred and eighty four patients (568 sites of third molar bilaterally), visiting the Department of Oral Medicine and Radiology were studied with Panoramic Radiograph to assess for agenesis of mandibular third molars bilaterally. Data was entered in Microsoft Excel sheet and transferred to Statistical Package for the Social Sciences version 11.5., Results: Out of 284 participants, 568 sites of mandibular third molars were evaluated and agenesis was seen among 163 (28.7%) participants at the confidence interval of 95% (28.643 to 28.757). Total numbers of patient with single missing mandibular third molar were 35 (6.2%). Twenty one had agenesis only on the right side and 14 had agenesis only on the left. The total number of patients with agenesis of both the mandibular third molars was 64 (22.5%)., Conclusions: Agenesis was highly prevalent in this study group. The likelihood of third molar being absent on one side, when there was concurrent missing third molar on the other side of mandible was also high.

The purpose of this study was to clarify differences in skeletal morphologies between male and female orthodontic patients with and without agenesis of all four third molars. A total of 64 patients (32 males and 32 females) with agenesis of all four third molars without agenesis of other teeth were selected as the third molars agenesis group (group 1). In addition, 64 patients (32 males and 32 females) with all these teeth were selected as controls (group 2). Lateral cephalograms taken between the ages of 14 and 30 years were used to compare skeletal morphology between groups 1 and 2 and between sexes. Maxillary length (P < 0.001), lower facial height (P < 0.05), gonial angle (P < 0.001) and mandibular plane angle (P < 0.001) were significantly smaller in group 1 than in group 2. Irrespective of the presence or absence of all four third molars, males had significantly smaller lower facial height (P < 0.01) and mandibular plane angle (P < 0.001) and significantly greater total mandibular length (P < 0.001), mandibular body length (P < 0.001) and mandibular ramus height (P < 0.001) than females. Japanese orthodontic patients with agenesis of all four third molars had significantly small maxillary length, lower facial height, gonial angle and mandibular plane angle.

The purpose of this investigation was to determine the impact of heritability on third molar agenesis in twins. The study sample consisted of 284 same sex twins (172 monozygotic and 112 dizygotic), whose mean ages were 19.7 ± 4.3 and 18.9 ± 4.8 years, respectively. The monozygotic group consisted of 36.3% males and 63.7% females, while the dizygotic group consisted of 50.1% males and 49.9% females. The zygosity of the twins was established using 15 specific DNA markers. The prevalence of third molar agenesis in monozygotic twins was 19.6%, which was higher than in the dizygotic twins group (15.50%) (p = 0.004). In both groups, third molar agenesis was more frequent in the maxilla than in the mandible (p = 0.000). Agenesis of the maxillary third molars was mostly affected by additive genetic factors (62-63%), with the common environment and the specific environment accounting for up to 25% and 13%, respectively. In contrast, agenesis of the lower third molars was associated with a higher additive genetic determination (81-83%), with the specific environment accounting for 17% to 19%. The study's conclusion is that the formation of the third molars follicle is strongly controlled by additive genetic factors.

The identification of clinical patterns of tooth agenesis in individuals born with craniofacial deformities may be a useful tool for risk determination of these defects. We hypothesize that specific craniofacial deformities are associated with third molar agenesis., Objective: The aim of this study was to identify if third molar agenesis could have a relation with other craniofacial structure alterations, such as cleft lip and palate, skeletal malocclusion, or specific growth patterns in humans., Design: Data were obtained from 550 individuals ascertained as part of studies aiming to identify genetic contributions to oral clefts. 831 dental records of patients aged over eight years seeking orthodontic treatment were also included. SN-GoGn angle were used to classify the growth pattern (hypo-divergent, normal and hyper-divergent), and the ANB angle was used to verify the skeletal malocclusion pattern (Class I, II and III). Panoramic radiographs were used to determine third molar agenesis., Results: A high frequency of third molar agenesis among individuals born with cleft lip with or without cleft palate (55%), as well as among their relatives (93.5%) was found. Third molar agenesis was not associated to skeletal malocclusion or growth pattern., Conclusion: It appears that third molar agenesis is associated with the disturbances that lead to cleft lip and palate., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: This study was designed to examine the relationship between third molar agenesis and skeletal morphology in the Chinese population., Materials and Methods: A total of 1043 patients' records were analyzed with panoramic radiographs and cephalograms. Congenitally missing third molars were assessed with respect to gender, jaw, and side, and assessed in various types of facial morphology. Linear, angular, and proportional cephalometric measurements were analyzed and compared among the samples. For the evaluation of results, the following statistics were used: the Pearson χ 2 test, one-way ANOVA, and the Student-Newman-Keuls method., Results: The overall prevalence of third molar agenesis was 28.7%. Missing third molars were more common in the maxilla and on the right side, while the difference was not statistically significant (P > 0.05) between genders. Every hypodontia group had a smaller SN-GoGn angle, Y-axis-FH angle, and a larger S-Go/N-Me ratio. The group with third molar agenesis in both jaws had smaller SNA and Wits values. The frequency of third molar agenesis in subjects with a Class II malocclusion was significantly lower than in other types of malocclusion (P < 0.05), and the incidence of third molar agenesis in hypodivergent growth pattern was higher than in other patterns (P < 0.05)., Conclusion: The results demonstrate a possible association between third molar agenesis and both sagittal and vertical craniofacial morphology.

Aim: To evaluate the shape of the craniofacial complex in patients with tooth agenesis and compare it to matched controls., Subjects and Methods: The sample comprised 456 patients that were allocated to three groups: the agenesis group of 100 patients with at least one missing tooth, excluding third molars, the third molar agenesis group (3dMAG; one to four missing third molars) of 52 patients and the control group (CG) of 304 patients with no missing teeth. The main craniofacial structures depicted on lateral cephalograms were digitized and traced with 15 curves and 127 landmarks. These landmarks were subjected to Procrustes superimposition and principal component analysis in order to describe shape variability of the cranial base, maxilla and mandible, as well as of the whole craniofacial complex. For statistical analysis, permutation tests were used (10 000 permutations without replacement)., Results: Approximately half of the sample's variability was described by the first three principal components. Comparisons within the whole sample revealed sexual dimorphism of the craniofacial complex and its structures (P < 0.01). Differences between the agenesis group and matched controls were found in the shape of all craniofacial structures except for the cranial base (P < 0.05). Specifically, patients with agenesis presented with Class III tendency and hypodivergent skeletal pattern. However, the comparison between the 3dMAG and matched CG revealed no differences., Conclusion: The shape of the craniofacial complex differs in patients with tooth agenesis suggesting that common factors are implicated in tooth development and craniofacial morphology., (© The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com)

Objective: The aim of this study is to explore patterns of non-syndromic permanent tooth agenesis in a large orthodontic patient group., Design: A record review was performed in various orthodontic clinics to identify white patients with non-syndromic permanent tooth agenesis, excluding 3rd molars. Four hundred and fourteen subjects fulfilled the inclusion criteria., Results: In the 414 subjects with tooth agenesis, approximately 70% presented 1-2 missing teeth. Symmetric agenesis patterns were often observed in the sample (by jaw, by side, or crossed quadrants), with prevalence approaching 30% for cases with contralateral tooth agenesis within a jaw. In cases with 1 or 2 missing teeth, from the total number of potential tooth agenesis patterns in the sample, a certain part was evident, limiting the variation to 27.8% (44/158). In the entire sample, both in the maxilla and the mandible a certain incisor/premolar agenesis phenotype was observed in 59.0% of cases in isolated form., Conclusions: Although there was variation in the tooth agenesis patterns, our findings suggest the involvement of particular genetic, epigenetic, and/or environmental factors in the formation of the entire dentition, which often lead to specific tooth agenesis phenotypes in cases where this process is disrupted. The present study provides a comprehensive categorization of orthodontic cases with tooth agenesis and can assist in planning future epidemiological and genetic studies., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Odontoma is considered to be the most common odontogenic tumor of the oral cavity. Most odontomas are asymptomatic and are discovered during routine radiographic investigations and can cause disturbances in the eruption of the teeth, most commonly delayed eruption or deflection. By a retrospective study design, demographic and clinical data regarding patients who presented odontomas from year 1995 to 2015 were obtained in order and the influence of active therapy on the dentition and on the treatment of impacted teeth was analyzed. Forty-five patients (mean age 14.2 years) with 29 complex and 16 compound odontomas were included in this retrospective study. Initial symptoms were delayed eruption of permanent teeth (n = 25), pain (n = 6), swellings (n = 4), and no symptoms (n = 10); 31 patients were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 2:1 (31/15). Thirty-two out of 45 odontomas were in close proximity of at least 1 tooth (n = 21 at incisive). A total of 12 teeth were extracted (complex: n = 8; compound: n = 4). Of the nonextracted teeth, 33 teeth were displaced and retained. Of those, 29 teeth were aligned through orthodontic-surgical approach and 4 teeth erupted spontaneously after surgery during the follow-up period. An early detection of odontoma is more likely an accidental radiological finding, hence the need for routine radiographic analysis should be emphasized. Early diagnosis of odontomas in primary dentition is crucial in order to prevent later complications, such as impaction or failure of eruption of teeth.

A genome-wide association study (GWAS) identifies regions of the genome that likely affect the variable state of a phenotype of interest. These regions can then be studied with population genetic methods to make inferences about the evolutionary history of the trait. There are increasing opportunities to use GWAS results-even from clinically motivated studies-for tests of classic anthropological hypotheses. One such example, presented here as a case study for this approach, involves tooth development variation related to dental crowding. Specifically, more than 10% of humans fail to develop one or more permanent third molars (M3 agenesis). M3 presence/absence variation within human populations has a significant genetic component (heritability estimate h 2 = 0.47). The evolutionary significance of M3 agenesis has a long history of anthropological speculation. First, the modern frequency of M3 agenesis could reflect a relaxation of selection pressure to retain larger and more teeth following the origins of cooking and other food-softening behaviors (i.e., the genetic drift hypothesis or, classically, the "probable mutation effect"). Alternatively, commensurate with increasing hominin brain size and facial shortening, M3 agenesis may have conferred an adaptive fitness advantage if it reduced the risk of M3 impaction and potential health complications (i.e., the positive selection hypothesis). A recent GWAS identified 70 genetic loci that may play a role in human M3 presence/absence variation. To begin evaluating the contrasting evolutionary scenarios for M3 agenesis, we used the integrated haplotype score (iHS) statistic to test whether those 70 genetic regions are enriched for genomic signatures of recent positive selection. None of our findings are inconsistent with the null hypothesis of genetic drift to explain the high prevalence of human M3 agenesis. This result might suggest that M3 impaction rates for modern humans do not accurately retrodict those of the preagricultural past. Alternatively, the absence of support for the positive selection hypothesis could reflect a lack of power; this analysis should be repeated following the completion of more comprehensive GWAS analyses for human M3 agenesis.

Background Third molar influence on anterior crowding is controversial, but they are assumed to play a major role in compromising dental arch space. Aim To evaluate the relationship among impaction, agenesis and crowding in black South African males. Subjects and method Mandibles and maxillae of 535 black South African males in the Raymond A. Dart Collection of Human Skeletons, University of the Witwatersrand were examined for anterior crowding and third molar agenesis and impaction. Dental crowding was determined using Little's irregularity index. Results Individuals with impaction showed more moderate-to-extreme crowding than those with agenesis. Bilateral third molar presence was more frequently associated with ideal-to-minimal crowding. Weak positive but significant correlations between crowding and impaction were found (mandible, ρ = 0.154, p = 0.000; maxilla ρ = 0.130, p = 0.000). The direction was the opposite for bilateral presence of molars (mandible, ρ = -0.135, p = 0.02; maxilla, ρ = -0.111, p = 0.010). Odds of mandibular crowding were greatest in individuals with impaction (OR = 3.22, CI = 1.716-6.05, p < 0.001). Maxillary results were similar. Conclusion Third molar impaction plays a role in anterior crowding. Third molar presence was not associated with anterior crowding, while agenesis did not explain absence of crowding.

Purpose: The aim of this study was to investigate the agenesis of third molars (M3) in children with permanent dentition in a limited population in the province of Izmir, Turkey., Study Design: The panoramic radiographs of 773 patients (457 females, 316 males) were evaluated retrospectively at the Dental Hospital of Ministry of Health in İzmir, Turkey. The patients' ages ranged from 12-18 years. The agenesis of M3 teeth was investigated according to maxilla and mandible and right and left distribution., Results: In 593 of the patients (76.7%), all of the M3 teeth were present in the mouth; while in the other 180 (23.3%) patients, agenesis of a varying number of M3 teeth was identified. In 31 patients (4.0%), total M3 tooth agenesis was observed. A statistically significant relationship was not found between gender and M3 teeth (p=0.091). A statistically significant relationship was found between congenital M3 tooth agenesis and the maxilla (14.3%) and mandible (9.6%) (p<0.001). However, a statistically significant difference was not found between the right-left area of the jaw (p=0.100)., Conclusion: As a result, while all M3 teeth were present in 76.71% of the population studied in the province of Izmir, agenesis of one or more than one M3 tooth was found in the other 23.29% of the patients studied.

Several mutations, located mainly in the MSX1 homeodomain, have been identified in non-syndromic tooth agenesis predominantly affecting premolars and third molars. We identified a novel frameshift mutation of the highly conserved C-terminal domain of MSX1, known as Msx homology domain 6 (MH6), in a Japanese family with non-syndromic tooth agenesis. To investigate the importance of MH6 in tooth development, Msx1 was targeted in mice with CRISPR/Cas system. Although heterozygous MH6 disruption did not alter craniofacial development, homozygous mice exhibited agenesis of lower incisors with or without cleft palate at E16.5. In addition, agenesis of the upper third molars and the lower second and third molars were observed in 4-week-old mutant mice. Although the upper second molars were present, they were abnormally small. These results suggest that the C-terminal domain of MSX1 is important for tooth and palate development, and demonstrate that that CRISPR/Cas system can be used as a tool to assess causality of human disorders in vivo and to study the importance of conserved domains in genes.

The purpose of this study was to measure the prevalence of enamel markings in routinely extracted third molars. One hundred donated third molars were examined. All had some marking(s). Caries was almost universal; white snowcapping of cusps and ridges was extremely common; pit and valley defects were very common; spots and bands were very common, most were white; horizontal grooves were common; linear enamel hypoplasia, considered to be a true developmental defect, was rare.

Background: Factors that can directly influence the extraction of third molars include the position of the tooth and the presence of root dilacerations. Knowledge of these features favors an accurate therapeutic evaluation of third molars; therefore, the aim of this study was to evaluate, using panoramic radiographs, the positioning of unerupted third molars with and without root dilacerations and to verify a possible association between these two variables., Methods: In this study, 16,136 panoramic radiographs were analyzed, including 1756 lower third molars, in which the positioning was assessed according to the Winter classification and the presence of root dilacerations was determined. The data obtained from the assessments of the frequencies of the positions and the presence of root dilacerations of impacted mandibular third molar was described. A χ2 test was applied to verify a possible association between the variables., Results: The results indicated that the most frequent position was mesioangular (44.5%), followed by horizontal (24.9%), vertical (17.4%), distoangular (12.5%), inverted (0.4%), and linguoangular (0.3%). Of the mandibular third molars evaluated, 35% had root dilacerations. The chi-square test revealed a significant association between the position of the tooth and the presence of root dilacerations (P<0.0001, χ2=34.28). The frequency of root dilaceration was statistically higher for the vertical (45.5%) and distoangular positions (40.9%)., Conclusions: The mesioangular position was the most prevalent location for lower third molars, and the highest frequencies of root dilacerations were observed in the vertical and distoangular positions. Knowledge about the prevalence of root dilacerations and the significant association between the position of the third molars and root dilacerations will allow safer surgical planning for dental extractions of third molars.

The purpose of this study was to investigate the patterns of bilateral agenesis of maxillary third molars and other tooth agenesis in Japanese orthodontic patients. A group of 262 subjects with bilateral agenesis of maxillary third molars (group A) was divided into three subgroups: group 1A consisting of 114 subjects without agenesis of mandibular third molars; group 2A, 31 subjects with unilateral agenesis of mandibular third molars; and group 3A, 117 subjects with agenesis of all third molars. As controls, 926 other subjects without third molar agenesis were selected (group C). Panoramic radiographs were mainly used to examine for tooth agenesis. The Chi square test and odds ratio were used to make statistical comparisons. The prevalence rates of agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, and bilateral agenesis of maxillary lateral incisors and second premolars were significantly higher in any one of the third molar agenesis groups than in the control group. Characteristically, no significant increase in occurrence of bilateral agenesis of mandibular second premolars was demonstrated by the subjects with bilateral agenesis of maxillary third molars. Irrespective of whether unilateral or bilateral agenesis of mandibular third molars is present or not, the Japanese orthodontic patients with bilateral agenesis of maxillary third molars exhibited a significantly increased occurrence of unilateral or bilateral agenesis of maxillary lateral incisors, mandibular incisors and maxillary and mandibular second premolars, except for bilateral agenesis of mandibular incisors and second premolars.

Introduction: The aim of this investigation was to study the relationship between third molar agenesis-including the number of ageneses-and craniofacial structure growth., Methods: We reviewed 305 clinical histories of patients treated at the Orthodontics Unit of the Faculty of Medicine and Dentistry at the University of Valencia in Spain. This included radiographic records of optimal quality. Of these, 40 patients who had agenesis of at least 1 third molar were included in the study group. A control group was formed with another 40 patients with all 4 third molars present. For both groups, a further criterion for inclusion was cone-beam computed tomography records. The cephalometric analysis was performed with NemoCeph 3D software (version 11.3.1.38; Nemotec, Madrid, Spain)., Results: The only significant differences between the 2 groups were in the total gonial angle and the upper gonial angle (P ≤0.05), both of which were smaller in the study group., Conclusions: Third molar agenesis is associated with a reduction in Jarabak's gonial angle and upper gonial angle, characteristic of patients with a more horizontal or brachyfacial skeletal pattern. No significant differences were found in other measurements., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

We aimed to consolidate all available data on worldwide third molar agenesis frequencies, with a particular emphasis on exploring the factors leading authors to find contradictory results for the demographic and morphologic predictors of this anomaly. A total of 12,376 studies were originally identified, then narrowed down to 1,312 for title/abstract screening. On the basis of our inclusion and exclusion criteria, we selected 92 studies, containing 100 effect sizes and 63,314 subjects, for systematic review and metaregression. The worldwide rate of agenesis was found to be 22.63% (95% confidence interval = 20.64% to 24.76%), although the estimates ranged from 5.32% to 56.0%. Our subgroup analyses revealed that women are 14% more likely than men to have agenesis of ≥1 third molars and that maxillary agenesis was 36% more likely than mandibular agenesis in both sexes. Furthermore, we found that having agenesis of 1 or 2 molars was most common, while agenesis of 3 or 4 molars was least common. Finally, we found large differences among agenesis frequency depending on geographic region. This information is expected to be of use not only to clinicians and patients but also to policy makers, given the implications for third molar extraction protocols., (© International & American Associations for Dental Research 2015.)

Objectives: In this study, the aim was to investigate a consanguineous Saudi family with non-syndromic premolars and third molars agenesis and to identify the causal mutation(s) using whole exome sequencing., Design: Family phenotype and family pedigree were constructed from clinical and radiographic examinations. Whole exome sequencing was performed in two affected members of the Saudi family using the SureSelect Human all Exon 50 Mb kit (Agilent Technologies, Inc., Santa Clara, CA) and then sequenced on an Illumina HiSeq. SNP and indel calling were performed using samtools version 0.18 and were annotated using the software ANNOVAR., Results: The family pedigree showed that the inheritance was autosomal dominant. Whole exome sequencing revealed that the affected members in this family were heterozygous with a novel frameshift mutation in exon 2 of the MSX1 gene, (NM&#95;002448:c.750&#95;751insACCGGCTGCC, p.F251PfsX92)., Conclusions: The novel MSX1 frameshift mutation was linked to a family with moderate to severe tooth agenesis phenotype affecting second premolars and third molars in both arches. This expands the genotype-phenotype of MSX1 associated conditions., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Successful root canal treatment depends on having comprehensive information regarding the root(s)/canal(s) anatomy. Dentists may have some complication in treatment of third molars because the difficulty in their access, their aberrant occlusal anatomy and different patterns of eruption. The aim of this review was to review and address the number of roots and root canals in third molars, prevalence of confluent canals in third molars, C-shaped canals, dilaceration and fusion in third molars, autotransplantation of third molars and endodontic treatment strategies for third molars.

This clinical case reports the treatment of an Angle Class II malocclusion in a young woman with a balanced face affected by agenesis of second and third mandibular molars and subsequent extrusion of second maxillary molars. The atypical and peculiar occlusal anomaly led to individualized treatment proposed in order to normalize dental malpositions, with subsequent rehabilitation of edentulous areas by means of a multidisciplinary approach. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for obtaining the title of certified by the BBO.

The purpose of this study was to investigate the patterns of third molar agenesis and incidence of agenesis of other permanent teeth in a Japanese orthodontic patient group. A total of 417 Japanese subjects (134 males and 283 females) with agenesis of one or more third molars were divided into four groups according to the agenesis pattern, and 874 other Japanese subjects (302 males and 572 females) without third molar agenesis were assigned to a control group. Panoramic radiographs and medical and dental records were used to examine for tooth agenesis. The Chi-square test and odds ratio were used to make statistical comparisons. The prevalence of third molar agenesis worked out at 32.3% with no statistically significant gender difference. A high prevalence rate of agenesis of third molars, unilateral or bilateral, could be considered characteristic of the Japanese orthodontic population. Significant increases in occurrence of oligodontia, and unilateral or bilateral agenesis of other teeth, including maxillary lateral incisors and maxillary and mandibular second premolars, were observed in all or almost all of the third molar agenesis groups, compared with the controls. A significantly increased prevalence rate of mandibular lateral incisor agenesis was observed in almost all of the third molar agenesis groups. The Japanese patients with third molar agenesis had a significantly increased occurrence of oligodontia, and unilateral or bilateral agenesis of maxillary and mandibular lateral incisors and second premolars, except for bilateral agenesis of mandibular lateral incisors.

The patient with painful restriction of jaw movements showed CT and MRI of TMJ signs of on-reducing disk displacement of the right TMJ and secondary arthrosis. Signs of occlusion obstacle and compression of the right TMJ structures have been revealed by studying of diagnostic models, MPI, investigation of TMJ with KAVO Arcus Digma II system. The etiological factor proved to be th dystopia of 4.8. Complete recovery of the TMJ function has been noted after removal of tooth 4.8. CT and MRI of TMJ, investigation of occlusion are indicated for patients with non-reducing disk displacement of TMJ. Malposition of third molar can lead to development of internal derangements of TMJ.

Vazirani-Akinozi technique was used in 82 patient undergoing oral surgery procedures. According to study results Vazirani-Akinozi technique was feasible in 89% of cases and particularly effective in surgical treatment of third lower molars eruption diseases complicated by inflammatory contracture. The method increases mouth opening 1.6-2.3 cm due to the soft-tissue anesthesia and partial anesthesia of masseter nerve. In case of inflammatory contracture of the jaws when inflammatory infiltration is spreading on the masseter muscle the authors recommend to use a combination of Vazirani-Akinozi and Berchet-Dubov techniques.

Introduction: Oral health is essential for combat readiness. The classification for combat readiness includes the Dental Fitness Categories, which are used to estimate a soldier's need for emergency dental care while deployed overseas. When the issue at hand is in regard to unerupted or additional teeth, the treating dentist faces a difficult decision since there is no evidence-based practice guidelines., Case Report: An otherwise healthy 20 year-old soldier initially presented to his general physician (Role I) with toothache in the lower jaw. The initial referral to a general dentist (Role II) led to a diagnosis of an additional tooth 45; therefore, he was transferred to the oral surgeon (Role III). A computed tomography scan revealed fully retained besides the additional 45, wisdom teeth, and additional wisdom teeth, as well as retained tooth 23. After careful consideration, osteotomies of all retained teeth were performed under general anesthesia. A titanium miniplate was placed for stabilization., Discussion: Despite variability among dentists in assigning a particular Dental Fitness Class, the clinical and radiologic examination must take into account treatment options that may become necessary for unerupted and retained teeth., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

The aim of this article was to describe imaging aspects of concrescence analyzed by three imaging modalities. A second molar joined together with a third molar was imaged using digital periapical radiography, cone beam computed tomography (CBCT) and micro-computed tomography (Micro-CT). On periapical radiograph, the mesial root of the third molar is superimposed on the distal root of the second molar. On CBCT images, a large cementum union between bulbous roots was detected, confirming the diagnosis of concrescence. On micro-CT images, the cementum union appeared limited to the apical third of the roots. In conclusion, both computed tomography modalities allowed for the diagnosis of concrescence. However, only micro-CT provided the real extension of the cementum union.

Unlabelled: Dental retentions have a high prevalence among the general population and their removal can involve multiple complications. The use of platelet rich plasma has been proposed in an attempt to avoid these complications, as it contains high growth factors and stimulates diverse biological functions that facilitate the healing of soft and hard tissues., Objectives: To evaluate the available scientific evidence related to the application of platelet-rich plasma in the post-extraction alveoli of a retained lower third molars., Material and Methods: A systematic review of published literature registered in the Medline, EMBASE, Cochrane and NIH databases. The following categories were included: human randomized clinical studies. Key search words were: platelet rich plasma; platelet rich plasma and oral surgery; platelet rich in growth factors and third molar., Results: Of 101 potentially valid articles, seven were selected, of which four were rejected as they failed to meet quality criteria. Three studies fulfilled all selection and quality criteria: Ogundipe et al.; Rutkowski et al.; Haraji et al. The studies all measured osteoblast activity by means of sintigraphy, and also registered pain, bleeding, inflammation, temperature, numbness as perceived by the patients, radiological bone density and the incidence of alveolar osteitis., Conclusions: Scientific evidence for the use of PRP in retained third molar surgery is poor. For this reason randomized clinical trials are needed before recommendations for the clinical application of PRP can be made.

PAX9 is a transcription factor expressed in the tooth mesenchyme during tooth morphogenesis. In Pax9-null mice, tooth development is arrested at the bud stage. In humans, heterozygous mutations in PAX9 have been associated with non-syndromic tooth agenesis, predominantly in the molars. Here, we report 2 novel mutations in the paired domain of PAX9, a three-nucleotide deletion (73-75 delATC) and a missense mutation (C146T), in two unrelated Japanese patients with non-syndromic tooth agenesis. The individual with the 73-75del ATC mutation was missing all maxillary molars and mandibular second and third molars. The individual with the C146T mutation was missing the mandibular central incisors, maxillary second premolars, and first molars, along with all second and third molars. Both mutations affected amino acids that are highly conserved among different species and are critical for DNA binding. When both mutants were transfected to COS7 cells, nuclear localization of PAX9 proteins was not affected. However, reduced expression of the mutant proteins and almost no transcriptional activity of the target BMP4 gene were observed, suggesting haploinsufficiency of PAX9 as the cause of non-syndromic tooth agenesis.

Tooth agenesis is the most common developmental anomaly of human dentition, occurring most often in the third molar (wisdom tooth). It is affected by genetic variation, so this study aimed to identify susceptibility genes associated with third molar agenesis. Examination of panoramic radiographs and medical history about third molar extraction were used to diagnose third molar agenesis. We then conducted a genome-wide association study of 149 cases with at least one-third molar agenesis and 338 controls from Japan and Korea using the Illumina HumanOmniExpress BeadChip. After rigorous quality-control filtering, approximately 550 000 single-nucleotide polymorphisms (SNPs) were analyzed in association tests with the status. We identified three SNPs showing evidence of association at P<1 × 10(-5) and 69 SNPs showing evidence of association at P<1 × 10(-4). SNP rs1469622, which maps to an intron of THSD7B (thrombospondin, type I, domain containing 7B) on chromosome 2, showed the strongest association (combined odds ratio=1.88, 95% confidence interval=1.43-2.47, P=7.5 × 10(-6)). The identified SNPs may be considered candidates for future replication studies in independent samples.

Objective: To investigate whether there is an association between dental developmental anomalies (DDAs) and different manifestations of class II division 2 (CII/2) malocclusion incisor retroclination., Design: Retrospective comparative study., Setting: Private orthodontic practice in the regions of Lisbon and Porto, Portugal., Subjects and Methods: The sample comprised 115 CII/2 malocclusions distributed into two groups on the basis of incisor retroclination: Group I composed of 48 CII/2 with retroclination exclusively of both maxillary central incisors; Group II composed of 67 CII/2 with retroclination of all four maxillary incisors. Using the initial orthodontic records, it was determined for each patient the presence of the following DDAs: tooth impaction, tooth agenesis, maxillary lateral incisor microdontia, tooth transpositions and supernumerary teeth., Results: Fifty-five per cent of patients were diagnosed with at least one of the DDAs studied. In the total sample the prevalence rates were: 20.0% of palatal maxillary canine impaction, 27.4% of third molar agenesis, and 15.7% of maxillary lateral incisor microdontia. No patient exhibited any transposition or supernumerary teeth. The distribution of the DDAs studied by groups revealed a strong association of palatal canine impaction, tooth agenesis and maxillary lateral incisor microdontia with Group II but not with Group I., Conclusion: The association of DDAs with CII/2 malocclusion is not common to all types of maxillary incisor retroclination, suggesting different etiologic factors among the different manifestations of CII/2 incisor retroclination.

The objective of this study was to classify the morphology of bifid mandibular canals and to evaluate their relationship with the roots of third molars, using cone beam computed tomography (CBCT) scans. The CBCT scans of 75 patients were analyzed and the bifurcations were classified according to Langlais et al. (1985). The relationship of bifurcation and third molars was established according to the following classification: class A--uninvolved, class B--close relationship, class C--intimate relationship and class D--absence of third molars. Data were submitted to descriptive statistics, and the results indicated that the patients' mean age was 48.2 (± 13.2) years. Unilateral bifurcation (Type 1) was the most frequent type (72.6%), followed by unilateral Type 2 (19.3%). Class D was the most frequent (57.33%), followed by class C (21.33%), class B (13.33%) and class A (8%). It could be concluded that most cases presented unilateral bifid mandibular canals extending to the third molar or adjacent regions, and when present, the roots seemed to be a continuation of the bifid mandibular canal.

Third molar presence in the infratemporal fossa is a rare event and it has been reported previously only two times in the literature, except for the cases which arise from complications occurring during the extraction of the impacted upper third molar. Due to the presence of important vessel bundles and nerves in this area, third molar removal requires a correct surgical management in order to avoid many possible serious side effects. We report an unusual case of upper third molar detected in the infratemporal fossa, which has been thoroughly investigated radiologically and removed through a safe surgical approach., (Celsius.)

EL/Sea mice are characterized by 100% incidence of agenesis of the third molars (M3). In a previous study, chromosomal mapping of the ninth generation EL/Sea congenic strains revealed a major locus for agenesis of M3, designated am3, in the 125-137 Mbp region of chromosome 3. In the present study, to determine the precise location of the am3 locus, we produced further generations of the EL/Sea congenic strains for am3 in which the restricted interval on chromosome 3 of EL/Sea was replaced by a MSM/Msf-derived homolog. The eleventh generation congenic mice that were either heterozygous or homozygous for the MSM/Msf-derived interval exhibited a significant decrease in the incidence of M3 agenesis (p < 0.00001). Results confined the am3 locus to an interval of 1 Mbp on chromosome 3, demonstrating that Lef1, one of the essential transcription factors for early tooth development, is the strongest candidate for am3.

Aim: To report rare findings of oral and periodontal manifestations in a patient with Epidermal nevus syndrome (ENS)., Background: The ENS describes the rare association of an epidermal nevus with abnormalities of central nervous system,ocular and skeletal abnormalities. Reports of oral involvement have been few. Also, most of the intraoral lesions have been reported in patients with nevi that do not fulfill the criteria for the diagnosis of ENS., Case Description: This report describes a case of ENS that, in addition to cutaneous manifestations showed skeletal involvement and intraoral manifestations such as the extension of the nevi on the face intraorally involving the labial mucosa, hypoplasia, hypodontia of teeth and severe periodontal destruction., Conclusion: Patients with extensive epidermal nevi and systemic abnormalities should be suspected of having the ENS. Evaluation and management of patients with ENS requires a multidisciplinary team approach involving the dermatologist, pediatrician, ophthalmologist, neurologist, genetist, plastic surgeon and orthopedic services. Although uncommonly described in association with ENS, significant intraoral lesions do occur. Periodontal manifestations as in our patient, which to our knowledge has not been described in association with ENS so far, may also be present., Clinical Relevance: Alteration of the response of periodontal tissues to dental plaque in the presence of certain systemic diseases has been reported, but not in association with ENS. Severe periodontal destruction due to exaggerated response to dental plaque was seen in the present case. Hence, emphasis on oral hygiene maintenance in such patients is essential. Patients with ENS must be evaluated periodically as they show a persistent predisposition for the development of tumors.

This case series shows male triplets with similarly positioned palatally displaced canines and agenesis of third molars. It supports findings reported previously in the literature suggesting a genetic origin for the palatally displaced canine and other dental anomalies which may be biologically related.

Odontodysplasia (ghost tooth) is an uncommon, nonhereditary developmental condition of unknown origin, affecting both mesodermal and ectodermal elements of the dental organ. To our knowledge, this case is unique in that it is only the second reported case of odontodysplasia affecting a single tooth. Based on clinical, radiographic and histologic findings, we diagnosed this tooth as a ghost tooth.

Background: A tooth is said to be ectopic if it is malpositioned either due to congenital factors or displaced due to pathological lesions. The incidence of osteomyelitis of condyle has a rare occurrence, very few cases have been reported, either their etiology is unknown or is due to hematogenous spread or a tuberculous focus. This particular case may be a rare of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle., Case Report: This report presents a unique case where an ectopically placed mandibular third molar led to extraoral sinus and scar formation below the ear lobule with osteomyelitis of the mandibular condyle and proposes various indications for its removal along with literature review., Discussion: Ectopic eruption of a tooth into the dental environment is common, whereas ectopic eruption of tooth in other sites is rare. The exact etiology of ectopic eruption of mandibular third molar in condyle is a rare occurrence and to the best of our knowledge, only 14 cases have been reported in the literature. Management of such cases should be meticulously planned after ruling out various local as well as systemic factors as an underlying cause for osteomyelitis and on the basis of the position and type of ectopic tooth and related potential trauma which could be caused by surgical intervention with less morbidity., Conclusion: This particular case may be the unique of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle. Diagnosis and management in such cases deserve very special attention to rule out various local and systemic causes which can cause osteomyelitis to affect very unusual site like mandibular condyle. The aim of surgical intervention should be to cause minimum morbidity without affecting the functional efficiency of the mandibular condyle. In this report, we also have proposed the indications for surgical intervention to remove ectopically erupted teeth.