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      Differences in the Eruption Angle of Palatally Displaced Canines in Klinefelter Syndrome: a Retrospective Study on Panoramic Radiographs

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          Abstract

          Objective

          To investigate the eruption angle of maxillary canine in patients with Klinefelter syndrome (KS) in which high prevalence of palatally displaced canine anomaly (PDC) has been found by clinical assessment.

          Subjects and Methods

          The sample consisted of 37 KS males aged 20-34 years (mean 27 years) and the control group which consisted of 78 healthy males aged 20-27 years (mean 23 years). A pioneer method was used to measure the eruption angle. It was based on determining the topographic construction of mandibular gonion line called GO-GO method on panoramic radiograph.

          Results

          The mean of eruption angle was increased for 10.58° in the right side and 9.69 ° in left side in patients with KS compared to those in the control group. The difference of mesioangular inclination of palatally displaced canines in Klinefelter patients was statistically significant (p< 0.01). When eruption angle in the control group was compared to Klinefelter patients, the statistical difference was confirmed for respective sides (P <0.01 for both).

          Conclusions

          The difference between eruption angle values in KS patients as well as in those belonging to the control group seemed to identify a developmental disturbance, thus confirming the fact that an extra X chromosome has an influence. The GO-GO method might be used for males when it is difficult to define occlusal planes, or for comparison. If this method is used, the eruption angular values should not exceed 56.74°.

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          Most cited references46

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          Early treatment of palatally erupting maxillary canines by extraction of the primary canines.

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            The palatally displaced canine as a dental anomaly of genetic origin.

            Palatal displacement of the maxillary canine tooth is a positional variation thought generally to develop as a result of local factors, such as retained deciduous canines, anomalous permanent lateral incisors, or dental crowding. This article contributes biologic evidence pointing to genetic factors as the primary origin of most palatal displacements and subsequent impactions of maxillary canine teeth. Data gathered from multiple sources are integrated to support a genetic etiology for the palatally displaced canine (PDC) on the basis of five evidential categories: 1. Occurrence of other dental anomalies concomitant with PDC; 2. Bilateral occurrence of PDC; 3. Sex differences in PDC occurrence; 4. Familial occurrence of PDC; 5. Population differences in PDC occurrence. From analysis of available evidence, the PDC positional anomaly appears to be a product of polygenic, multifactorial inheritance.
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              The etiology of maxillary canine impactions.

              The etiology of tooth impactions has long been related to an arch-length deficiency. This is valid for most impactions, but not for palatal impaction of the maxillary canine. This study shows that 85 percent of the palatally impacted canines have sufficient space for eruption. The bud of the maxillary canine is wedged between the nasal cavity, the orbit, and the anterior wall of the maxillary sinus. The buds of the lateral incisor and the first premolar are located behind the canine's palatal surface. An arch-length deficiency will not allow the maxillary canine to "jump" the buds, the nasal cavity, or the sinus in order to reappear in the palate. A canine can be palatally impacted if an extra space is available in the maxillary bone. This space can be provided by (1) excessive growth in the base of the maxillary bone, (2) space created by agenesis or peg-shaped lateral incisors, or (3) stimulated eruption of the lateral incisor or the first premolar. In those conditions the canine is free to "dive" in the bone and to become palatally impacted. A dysplasia in the maxillary-premaxillary suture can also modify the direction of the maxillary canine's eruption.
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                Author and article information

                Journal
                Acta Stomatol Croat
                Acta Stomatol Croat
                ASC
                Acta Stomatologica Croatica
                University of Zagreb School of Dental Medicine, and Croatian Dental Society - Croatian Medical Association
                0001-7019
                1846-0410
                December 2017
                December 2017
                : 51
                : 4
                : 300-308
                Affiliations
                [1 ]Department of Orthodontics, Pedodontics and Preventive Dentistry, Faculty of Dental Medicine and Oral Surgery, Tripoli University , Libya
                [2 ]Department of Dental Anthropology, School of Dental Medicine University of Zagreb & University Clinical Hospital Center Zagreb , Croatia
                [3 ]Department of Dental Anthropology, School of Dental Medicine University of Zagreb , Croatia
                Author notes
                Corresponding author: 
Associate Professor Ahmed Abulwefa, PhD 
Tripoli University
Faculty of Dental Medicine and Oral Surgery
Department of Orthodontic-Pedodontic-Preventive Dentistry
Tripoli, Libya 
 abulwefa2009@ 123456yahoo.com
                Article
                ASC_51(4)_300-308
                10.15644/asc51/4/4
                5975455
                db6926d3-a1d6-4f1a-bb8c-fddd7848ff93
                Copyright @ 2017

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License.

                History
                : 09 May 2017
                : 06 November 2017
                Categories
                Original Scientific Papers

                klinefelter syndrome,tooth eruption, ectopic,palate, hard,canine,panoramic radiography,sex chromosome disorders

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