|Year : 2015 | Volume
| Issue : 1 | Page : 83-86
Prevalence of taurodontism among the patients visiting a dental teaching hospital in Pune, India: A retrospective orthopantomogram study
Dipali Shah1, Vikram Garcha2, Janardan Garde3, Devendra Ekhande1
1 Department of Conservative Dentistry, Sinhgad Dental College and Hospital, Vadgaon Budruk, Pune, Maharashtra, India
2 Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Vadgaon Budruk, Pune, Maharashtra, India
3 Department of Oral and Maxillofacial Surgery, Sinhgad Dental College and Hospital, Vadgaon Budruk, Pune, Maharashtra, India
|Date of Web Publication||19-Mar-2015|
Dr. Dipali Shah
Department of Conservative Dentistry, Sinhgad Dental College and Hospital, S.No. 44/1, Vadgaon Budruk, Pune - 411 041, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Taurodontism is a morpho-anatomic variation in the shape of teeth that chiefly affects molars in primary as well as secondary dentition. Aim: The aim was to assess the prevalence of taurodontism in premolars and molars by studying the orthopantomogram (OPGs) of the patients visiting a dental teaching hospital in Pune, India. Materials and Methods: A retrospective, cross-sectional study was carried out, wherein the panoramic radiographs of 525 randomly selected patients were evaluated for taurodontism. A detailed medical and family history record of the patients was also obtained. Radiographic analysis for taurodontism was carried out in premolars and molars. Prevalence of taurodontism was assessed, and a comparison among male and female prevalence was done using the z-test. Results: Prevalence of taurodontism was 11.8%. Taurodontism was exhibited in 12.5% females and 9.7% males. Unilateral taurodontism was seen in 24 (4.57%) and bilateral taurodontism in 38 (7.23%) of the 525 OPGs. Mandibular second molars were the teeth most commonly affected by taurodontism. Conclusion: There was a high prevalence of taurodontism in patients visiting the dental teaching institute. Orthopantamogram can be used effectively to detect taurodontism. The findings of this study revealed that premolars may also be affected with taurodontism.
Keywords: Molar, premolar, prevalence study, taurodontism, teeth
|How to cite this article:|
Shah D, Garcha V, Garde J, Ekhande D. Prevalence of taurodontism among the patients visiting a dental teaching hospital in Pune, India: A retrospective orthopantomogram study. J Indian Assoc Public Health Dent 2015;13:83-6
|How to cite this URL:|
Shah D, Garcha V, Garde J, Ekhande D. Prevalence of taurodontism among the patients visiting a dental teaching hospital in Pune, India: A retrospective orthopantomogram study. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2019 Dec 15];13:83-6. Available from: http://www.jiaphd.org/text.asp?2015/13/1/83/153601
| Introduction|| |
Morpho-anatomic traits are of importance in studying regional population affinities and phylogenetic predilections. Taurodontism is one such morpho-anatomical variation in the shape of teeth such that the body of the tooth is enlarged at the expense of the size of the roots. The affected teeth exhibit three characteristic features, namely-the floor of the pulp chamber is apically displaced with bifurcation/trifurcation of roots, lack of the usual constriction at the cemento-enamel junction of the teeth and elongated pulp chamber.  Diagnosis of taurodontism has been based on features that are characteristically best visualized on the radiograph.  Although permanent molar teeth are most commonly affected, reports have indicated that taurodontism may not be limited to molars as it also occurs in the premolar teeth.  Taurodontism may complicate endodontic, orthodontic, and/or prosthetic treatment planning. It has been associated with certain syndromes and some genetic defects, but its true significance is still obscure. ,
Review of the literature reveals a wide discrepancy in the prevalence of taurodontism in different population. Its prevalence has been reported in fossil remains of the Neanderthal race to the Inuit (Eskimo) race as well as in modern dentition.  In studies conducted, the prevalence rate ranged between 5.6% and 48% among molar teeth. ,
A majority of studies have not considered both premolar and molar teeth in their prevalence evaluation or have not stated exactly which teeth were assessed. ,, Quantitative studies of prevalence, however, have been limited to studies of Americans,  Australian aborigines,  Chinese,  Israeli,  Jordanian,  Saudi Arabian  population. Studies on the prevalence of taurodontism in western India are lacking. Premolars, in addition to the molars, need to be assessed for prevalence of taurodontism. Hence, the aim of this study was to assess the prevalence of taurodontism in premolars and molars using orthopantomograms.
| Materials and Methods|| |
The study was approved by the Institutional Research Board and Institutional Ethics Committee. A retrospective analysis of 1080 orthopantomogram (OPGs) of patients who had reported to Sinhgad Dental College and Hospital, Pune was done. The OPG records made during the time period of January 2011 to December 2012 were studied. Of 1080 randomly selected OPGs, 525 OPGs were selected for the study purpose which followed the inclusion and exclusion criteria of the study.
- Patients above the age of 14 years who had their OPG made due to various treatments required
- Taurodontism was identified based on the following criteria: ,
- Teeth that exhibited large pulp chamber in relation to the tooth
- Less prominent cervical constriction
- Apically displaced pulp chamber
- Apically displaced furcation and bifurcated short roots.
- Teeth with incomplete root formation
- Undetectable furcation and fused roots
- Premolars extracted for orthodontic reasons
- Carious teeth, restored teeth, fractured teeth
- Un-erupted third molars
- Poor quality of OPGs.
Before the commencement of the study, two independent oral radiologists who were not part of the study were trained to record taurodontism in premolars and molars, using the defined identification criteria of taurodontism in OPG records. , After training, both these examiners examined 25 OPG records for inter examiner reliability. For assessing intra examiner reliability, each examiner was made to analyze the same 25 OPG records at two different intervals of time at an interval of 3 weeks. Kappa statistics was applied to assess the reliability scores. Kappa statistics score of 1 was obtained for both the inter and intra examiner reliability indicating total agreement. 
Nature of information collected
A total of 525 OPG records were visually examined and recorded for taurodontism in premolars and molars by the trained oral radiologists [Figure 1] and [Figure 2]. Finally, patients' case history records were analyzed for any possible association with other dental anomalies or co-existing genetic diseases or syndromes. Data were compiled on a Microsoft Excel Sheet (Microsoft corporation, Redmond, WA, USA), and relevant frequency and percentages were calculated.
|Figure 1: Orthopantomogram showing unilateral taurodontism seen in mandibular left second molar and maxillary left first molar|
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|Figure 2: Orthopantomogram showing bilateral taurodontism in mandibular third molars and unilateral taurodontism in mandibular second molar|
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| Results|| |
The mean age of the patients in this study group was 27.5 years with an age range of 15 and 63 years. Of the 9022 teeth, 3976 were premolars and 5046 were molars, 100 (1.11%) teeth were found to have taurodontism. Taurodontism was detected in 62 of 525 subjects thus showing a prevalence of 11.8%. Prevalence of taurodontism among males was 12.5% and amongst females was 9.7% [Table 1]. Comparison of prevalence of taurodontism amongst males and females using z-test showed statistically nonsignificant results (P = 0.5995). Percentages of males exhibiting unilateral and bilateral taurodontism were 4.73% and 6.62%, respectively, and that of females exhibiting unilateral and bilateral taurodontism were 4.32% and 8.17%, respectively [Table 2]. Medical records showed four cases of taurodontism with diabetes mellitus. Of these four patients, three patients had bilateral taurodontism, and one patient had unilateral taurodontism.
|Table 1: Number and percentage of males and females affected by taurodontism |
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| Discussion|| |
Since the first observation of cylindrical or prismatic teeth in prehistoric hominids  to modern man, there have been variations in the prevalence of taurodontism in the human dentition. Although it was previously thought to be an atavistic or retrogressive trait, today it is considered as an anatomic variant and could occur in a normal population. 
Taurodontism can present challenges to various dental procedures routinely carried out for the patients seeking dental treatment. Taurodontism affects procedures such as cavity preparation, extractions, and orthodontic therapy. In addition, endodontic treatment in taurodont tooth has been described as complex and difficult. It could hamper localization of the orifices, thus creating difficulty in instrumentation and obturation. Furthermore, its association with several syndromes and abnormalities has been reported. Taurodont teeth are reported in patients with Down syndrome, Klinefelter syndrome, Mohr syndrome, Dwarfism, Oligodontia, Cleft lip, and Cleft palate. 
Prevalence of taurodontism in the modern dentition has shown considerable variation. This variability observed may be attributed to genetic and racial differences; sample selection, study methodology.  Premolars and third molars were included in the present study. This could explain the slightly higher prevalence rate than other studies. , A similar study in North India,  that included both premolars and molars, exhibited a prevalence of 5.5% as compared to 11.8% found in this study. This may be attributed to the racial and ethnic variations in the populations studied.
Pillai et al.  found a prevalence of taurodontism in premolars in 11.28% of the OPGs examined whereas in another study by Madeira et al.  none of 1010 maxillary premolars exhibited taurodontism. In the present study, only three maxillary premolars were affected among 525 OPGs. Only one mandibular premolar exhibited taurodontism, and this could be ascribed to the radiographs which depict teeth only in the mesiodistal orientation.  Use of three-dimensional radiographic studies like volumetric tomography (cone beam computed tomography) shall overcome the shortcoming in recording the prevalence of taurodontism in premolars which was a limitation of this study.
Mandibular second molars were the most affected teeth in the present study which is in accordance with studies by Keene  and by Blumberg et al.  A recent study in Iran evaluated frequency of taurodontism in both premolars and molars and reported the prevalence of taurodontism to be 5.5%.  Furthermore, unilateral taurodontism was more prevalent than bilateral taurodontism. , But in the present study, bilateral prevalence of taurodontism was more as compared to patients affected with unilateral taurodontism. Maxillary incidence of taurodontism was low. This could also be attributed to the interference of adjoining structures like zygomatic arch and loss of contrast.
Medical history records were checked to find if there was an association with anomalies or syndromes or systemic illness. Although medical records showed that taurodontism was seen in patients with diabetes mellitus, no association can be drawn with this condition. More studies in patients with systemic illness and syndromes should be conducted to find an association if any.
Use of OPGs, which are two-dimensional can view tooth only in mesio-distal plane, superimposition of anatomical interferences in the maxillary arch may have led to shortcomings in the study. Further studies could use volumetric computerized tomography records to study taurodontism.
| Conclusion|| |
Taurodontism is a morpho-anatomic variation with implications in dental practice.Hence, it needs to be studied for regional and racial variations if any. The prevalence of taurodontism in the present study was more as compared to studies in other parts of the country. A multi centric study on the prevalence of taurodontism in this region and use of volumetric computerized tomography as records could give more conclusive evidence.
| Acknowledgment|| |
We thank the Department of Oral Radiology, Sinhgad Dental College, Pune for providing support in this project.
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[Figure 1], [Figure 2]
[Table 1], [Table 2]