Year : 2006 | Volume
: 24 | Issue : 1 | Page : 42--44
Taurodontism of deciduous and permanent molars: Report of two cases
Ashwin Rao, R Arathi
Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Karnataka, India
Department of Pedodontics and Preventive Dentistry, Seema Dental College & Hospital, Veerpur- Khurd, Hrishikesh-249203, Uttaranchal
Taurodontism is an aberration of teeth that lacks the constriction at the level of the CEJ characterized by elongated pulp chambers and apical displacement of bifurcation or trifurcation of the roots, giving it a rectangular shape. Its occurrence in permanent teeth is common and is quite rare in deciduous dentition. Presented in this article are two cases with taurodontism involving deciduous and permanent molars.
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Rao A, Arathi R. Taurodontism of deciduous and permanent molars: Report of two cases.J Indian Soc Pedod Prev Dent 2006;24:42-44
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Rao A, Arathi R. Taurodontism of deciduous and permanent molars: Report of two cases. J Indian Soc Pedod Prev Dent [serial online] 2006 [cited 2020 Jan 19 ];24:42-44
Available from: http://www.jisppd.com/text.asp?2006/24/1/42/22836
The term taurodontism was first introduced by Sir Arthur Keith in 1913. It refers to a tooth form characterized by an external block configuration with an elongated body tending to enlarge at the expense of the root. Teeth with pulp chambers that are relatively small and have constriction of the pulp chamber at approximately the CEJ and are called as cynodonts. The taurodontic teeth are identified by elongated pulp chambers and apical displacement of bifurcation or trifurcation of the roots. Due to this, the chamber has a greater apicoocclusal height than in cynodont teeth and lacks the constriction at the level of the CEJ giving it a rectangular shape. So the distance from the bifurcation of roots to the CEJ is greater than the occluso cervical distance., Etiology of taurodontism is diverse commonly attributed to the failure of invagination of the epithelial root sheath sufficiently early to form the cynodont. Autosomal transmission of the trait has also been observed. Taurodontism can occur alone limited to one or more teeth or it can be associated with various syndromes like Down's syndrome, Klinefelter's syndrome etc., Taurodontism may be unilateral or bilateral and affects permanent teeth more frequently than primary teeth. It is commonly observed among the Eskimos and Natives of Australia and Central America.,, Taurodontism may be classified as mild, moderate and severe (Hypo, Meso and Hyper respectively) based on the degree of apical displacement of the pulpal floor, as explained in [Figure 1]. Presented here with are two cases of taurodontism involving deciduous and permanent molars.
A 7 ½ year old male patient reported to the dental clinic with complaint of pain in the lower left and right posterior region. The first and the second deciduous molars on both sides were having deep caries. IOPA of grossly decayed teeth revealed the presence of taurodontism of deciduous second molars on both the sides. Further evaluation revealed that even the first permanent molars were taurodontic [Figure 2]a, b. Curiosity prompted us to take OPG (after getting the consent from the parents) to evaluate the entire dentition. OPG revealed all the first permanent molars to be taurodontis [Figure 2]c. The upper first permanent molars were hypertaurodonts whereas the lowers were mesotaurodonts. The first deciduous molars in the lower orch and both the first and second molars in the upper orch were of normal shape and configuration. Altogether there were 4 permanent and 2 deciduous teeth that were taurodonts. Since the premolars were still in their developmental stage, it was difficult to assess them.
Other features were an additional distal canal in the lower right second deciduous molar and pulpstones in the pulp chamber of the left and right first permanent molars.
The affected tooth had to be treated by pulpectomy procedure. During the procedure, we confirm that the pulp chamber was large and filled entirely by the pulp tissue. The root canal was comparatively reduced in length but this did not affect the working length as the entire length of the tooth was relatively same.
A 5 year old female patient reported to our dental clinic with dental caries. During radiographic investigations, we found that both the second deciduous molars in the lower quadrants were taurodontic. The right second deciduous molars was a hypertaurodont and that on the left side was a mesotaurodont [Figure 3]. Surprisingly the molars in the upper quadrants were not uninvolved. This patient had two deciduous molars that were taurodontic. Both the involved teeth had pulp stones in the pulp chamber. Permanent molars or premolars could not be evaluated as they were in their developmental stage.
In the first case four permanent and two deciduous molars and in the second case two deciduous molars exhibited taurodontism. Taurodontism can occur as an isolated case or as a component of specific syndromes. In our case, both the patients had no systemic diseases or syndromes., Most reports reveal that permanent teeth are more frequently affected than deciduous teeth. In our cases both the deciduous and permanent molars were involved. The teeth that were diagnosed as taurodont were of both the meso and hyper varieties. Ronald et al in his cases demonstrated short, conical and misshapen roots with pulp stones in the pulp chamber of taurodontic teeth. In both the presented cases there where pulp stones seen obliterating the pulp chamber. Mandibular molars are found to be affected more often than maxillary molars. We found taurodontism affecting both the maxillary and mandibular molars with more number of involved teeth in the mandible. Taurodontism of the premolars was reported by Tiku et al , but since the premolars were still in the developing stage they could not be evaluated. As a taurodont shows wide variation in the size and shape of the pulp chamber with varying degrees of obliteration and canal configuration, root canal therapy becomes a challenge. Hence the authors would like to stress on the importance of diagnostic radiographs for early identification of a taurodonts and rendering preventive care to these teeth.
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