Prevalence and morphological features of molar-root incisor malformation from a specialist pediatric dental unit.

BACKGROUND: Molar-root incisor malformation (MRIM) is a rare dental anomaly featuring constricted cervical margins and tapered, narrow root and pulp morphology, often associated with severe toothache and infection.

AIM: The aim of this study was to determine the prevalence of MRIM in children seen in a specialist pediatric dental unit of a tertiary referral hospital and to describe the characteristics of affected individuals.

DESIGN: An audit of children attending from November 2020 to November 2021. Radiographs were used to identify individuals with MRIM, and clinical data were collated. In addition, histology and micro-computed tomography (microCT) imaging were performed on teeth extracted from an affected individual.

RESULTS: The prevalence of MRIM was 5 cases out of 1,054 children examined (0.47% or 1:210). The permanent first molars were affected in all 5 children and the primary second molars in 2 children; all children had medical comorbidities and multiple exposures to general anesthesia before 4 years of age. In addition, histological and microCT analyses displayed numerous micro-channels connecting the pulp chamber to the external surface of the tooth at the furcation.

CONCLUSIONS: MRIM is an uncommon dental anomaly affecting pediatric patients with multiple comorbidities and is characterized by porosities extending from the pulp chamber to the external tooth surface, predisposing the risk of bacterial ingress from the oral cavity into the pulp chamber. Early detection may prevent atypical odontogenic facial pain and infection.