Two developmental anomalies of the teeth 

 and resulting secondary pathosis 



Gabor Kocsis and Antonia Marcsik 



Among dental developmental anomalies are alterations of 

 shape and size. These include, among others, the dens invag- 

 inatus and the palato-gingival groove. The latter is con- 

 sidered a form of invagination (Lee et al. 1968:18; Walker 

 and Glyn Jones 1983:34). The clinical importance of both is 

 that they promote the formation of periodontal and periapical 

 pathosis (Lee etal. 1968: 16; Simon etal. 1971:823; Aboyans 

 and Ghaemmaghami 1976:65). 



The purpose of our study was to determine the prevalence 

 of these two developmental abnormalities. We examined the 

 difference in frequencies between archeological material and 

 recent samples. In archeological material from the seventh- 

 eighth centuries a.d. we investigated their simultaneous oc- 

 currence and their prevalence on one or two sides, their sex 

 dimorphism, as well as their incidences in the teeth of Eu- 

 ropoid and Mongoloid skulls. We also present pathologic 

 phenomena induced by the palato-gingival groove. 



Dens invaginatus (invaginated odontome or dens in dente) 

 is a well-known developmental anomaly occurring as a result 

 of invagination of the tooth germ before its calcification, 

 creating a pouchlike defect. It may be found in any tooth 

 germ but the maxillary incisors are most frequently affected 

 (Aboyans and Ghaemmaghami 1976:63). According to Hal- 

 lett (1953:496) the invagination is over eight times more 

 frequent in the upper lateral incisors than in the central ones. 



There are two types of invagination: coronal and radicular. 

 It has also become customary to divide coronal invaginations 

 into superficial and deep ones (Schuize 1970:108-109). Hal- 

 lett's classification ( 1 953:492) is most widely accepted: ( 1 ) A 

 definite cleft is formed in the palatal enamel at the cervical 

 level. This cleft runs vertically and there is no expansion or 

 dilatation; (2) the invagination extends toward the pulp 

 chamber and a definite pit is formed in the cingulum; (3) the 

 invagination extends deeply into the pulp chamber and is 

 dilated; (4) the invagination apparently occludes the whole of 

 the coronal pulp chamber and may extend beyond the amelo- 

 cemental junction level. 



Schranz's study (1987:78) is also remarkable. He difler- 

 cntiated the following invaginations on the palatal surface of 

 the upper incisors: "blind pit" (foramen caecum dcntis), im- 



Zagreb Paleopathology Symp. J 988 



perfect invagination (pouch or funnel-like tooth), perfect in- 

 vagination (dens in dente, dens invaginatus) and palatal in- 

 vagination. 



The pathogenesis of the coronal invagination is not en- 

 tirely known. Schuize ( 1970: 1 10- 1 1 1 ) wrote about a single, 

 active proliferation or passive retardation of a circumscribed 

 area of epithelium, or that possibly it is formed by union of 

 adjacent teeth. Grahnen et al. (1959:131-132) drew atten- 

 tion to the fact that dens invaginatus is genetically deter- 

 mined. Photographs and x-rays of dens invaginatus are 

 shown in Figures 1-3. 



Figure 1. Palatal invagination in maxillary lateral incisors. 

 Szegvar-Oromdiilo, Grave 83, 7th century. 



FiGURF. 2. Palatal invagination from apical direction in max- 

 illary lateral incisors. Szegvar-Oromdiilo, Grave 83, 7th cen- 

 tury. 



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