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J Dent Res 85(2):167-171, 2006
© 2006 International and American Associations for Dental Research

RESEARCH REPORT
Clinical

Origin of the Deciduous Upper Lateral Incisor and its Clinical Aspects

M. Hovorakova1,2,*, H. Lesot3,4, R. Peterkova1, and M. Peterka1,5

1 Department of Teratology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 20 Prague 4, Czech Republic;
2 Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Vinicna 7, 128 00 Prague 2, Czech Republic;
3 INSERM U595, 11 rue Humann, 67085 Strasbourg Cedex, France;
4 Université Louis Pasteur, Faculté de Chirurgie Dentaire, 67085 Strasbourg, France; and
5 Clinic of Plastic Surgery, Faculty Hospital Kralovske Vinohrady, Srobarova 50, 100 34 Prague 10, Czech Republic

* corresponding author, marhor{at}biomed.cas.cz


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 MATERIALS & METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
The upper lateral incisor in humans is often affected by dental anomalies that might be explained developmentally. To address this question, we investigated the origin of the deciduous upper lateral incisor (i2) in normal human embryos at prenatal weeks 6–8. We used serial frontal histological sections and computer-aided 3D reconstructions. At embryonic days 40-42, two thickenings of the dental epithelia in an "end-to-end" orientation were separated by a groove at the former fusion site of the medial nasal and maxillary processes. Later, these dental epithelia fused, forming a continuous dental lamina. At the fusion site, i2 started to develop. The fusion line was detectable on the i2 germ until the 8th prenatal week. The composite origin of the i2 may be associated with its developmental vulnerability. From a clinical aspect, a supernumerary i2 might be a form of cleft caused by a non-fusion of the dental epithelia.

KEY WORDS: lateral incisor • dental epithelium • human tooth development • orofacial cleft • dental anomalies


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
MATERIALS & METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
In humans, the upper lateral incisor is often affected by dental anomalies such as agenesis, alterations of shape and size, and supernumeraries (Ravn, 1971; Jarvinen and Lehtinen, 1981; Stamatiou and Symons, 1991). In a normal population of 3- to 3.5-year-old children, Ravn (1971) found that half of the supernumerary teeth in the primary dentition were maxillary lateral incisors.

Upper lateral incisor abnormalities are frequently associated with different types of orofacial clefts (Jordan et al., 1966; Tsai et al., 1998). In children with a unilateral complete cleft lip and palate, Tsai et al.(1998) observed four distribution patterns of the primary upper lateral incisor on the cleft side: (a) one lateral incisor located distally to the alveolar cleft, (b) one lateral incisor located mesially to the alveolar cleft, (c) the absence of the lateral incisor, and (d) the presence of two lateral incisors—one tooth on each side of the alveolar cleft.

In a normal population, the prevalence of supernumerary teeth is less than 1% for the primary dentition (e.g., Ravn, 1971; Jarvinen and Lehtinen, 1981). However, in patients with a cleft lip, the incidence of a supernumerary lateral incisor varies between 40% and 73% in the primary dentition (Böhn, 1963; Hansen and Mehdinia, 2002). In the permanent dentition, supernumerary lateral incisors were found in 42% of cleft patients (Böhn, 1963). Supernumerary lateral incisors are more frequent in the deciduous dentition than in the permanent one (Böhn, 1963; Tsai et al., 1998; Hansen and Mehdinia, 2002).

The morphology of the human face is established between the 5th and 10th prenatal weeks. An upper jaw arch is formed by the fusion of the paired medial nasal and maxillary facial processes (Figs. 1A, 1B, 1DGo). After ossification, the upper jaw consists of the maxillary bone and premaxilla, separated by the incisive suture. However, the incisive suture is not located where the embryonic facial processes fuse (Lisson and Kjaer, 1997; Tsai et al., 1998; Barteczko and Jacob, 2004). During prenatal development, the medial part of the maxillary process delivers material to the future premaxilla (Lisson and Kjaer, 1997; Barteczko and Jacob, 2004). The premaxilla carries the upper central and lateral incisors.


Figure 1
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  		Figure 1. Scheme of the early development of the human upper jaw and dental arch. (A,B,C) Frontal view of the embryonic human face in the 5th (A) and 6th/7th (B,C) weeks of development. (A) The medial nasal (mn) and the maxillary (mx) processes before fusion. (B) Normal development; the mn and mx are fused. (C) Unilateral left-sided cleft; the mn and mx are fused on the right and not fused on the left side. ln, lateral nasal process. (D,E,F) Scheme of the development of the human upper jaw viewed from the oral cavity. (D) Normal development. The fusion of the dental epithelia is delayed compared with the facial processes. At the site of fusion of the dental epithelia, the germ of the lateral incisor (i2) emerges, containing material from both the mn and the mx. (E) The development of a unilateral left-sided cleft of the dental epithelium. The dental epithelia on the left side are clefted, giving rise to two i2. (F) The development of a unilateral left-sided alveolar cleft. Non-fusion of the mn and mx on the cleft side results in the jaw cleft and, consequently, in the non-fusion of the dental epithelia and the formation of two i2. Line pattern: dental epithelium of mn, reticulation-dental epithelium of mx.

 
The developmental origin of the upper deciduous lateral incisor is not clear. It is generally believed that the human upper deciduous incisors originate from the medial nasal process. In macaques, it has been suggested that the primary maxillary central and lateral incisors are derived from the medial nasal and maxillary processes, respectively (Wei et al., 2000). In humans, Ooë (1957) has proposed that the upper lateral incisor can originate partly on the maxillary and partly on the medial nasal process.

The aim of our study was to search for the origin of the deciduous upper lateral incisor in normal human embryos at prenatal weeks 6–8, to elucidate the reasons for the developmental vulnerability of this tooth.


   MATERIALS & METHODS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS & METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
The development of the upper dental epithelium was examined in a collection of serial histological sections held by the Department of Teratology IEM in Prague. The collection consists of 53 normal embryos (artificial interruption of unwanted gravidity) and was constituted from the 1960s to the 1980s.

Histology
After fixation in Bouin-Hollande fluid or in 10% formol, the heads were embedded in paraffin, cut in series of 10-µm-thick frontal sections, and stained with hematoxylin-eosin or by a modified Mallory method.

3D Reconstructions
3D reconstructions of the dental epithelium have been performed in a representative sample of 8 normal human embryos showing a longitudinal series of tooth development (Hovorakova et al., 2005). The right or left upper jaw quadrant was selected randomly (TableGo).


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  		Table. Survey of the Material Used for 3D Analysis
 
Contours of the dental and adjacent oral epithelium were drawn from the serial histological sections at 10-µm intervals (magnification x120–260, depending on the size of the specimen), under a LEICA DMLB (Leica Microsystems, Wetzlar, Germany) or JENAVAL (Carl Zeiss, Jena, Germany) microscope equipped with a drawing chamber.The superimposition of the serial drawings was performed by the "best-fit" method. The digitalization and the correlation of successive images have previously been described (Lesot et al., 1996). Three-dimensional images were generated by a volume-rendering program (Sun Voxel, Sun Microsystems, Santa Clara, CA, USA).


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS & METHODS
 RESULTS
DISCUSSION
 REFERENCES
 
During prenatal weeks 6–8, the place of fusion between the former medial nasal and maxillary outgrowths could be detected on the dental and vestibular epithelia in 3D reconstructions viewed from the mesenchymal aspect (Fig. 2Go; Appendix Figs. 4, 5, 6).


Figure 2
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  		Figure 2. Computer-aided 3D reconstructions of the epithelium on the oral surface of the right upper jaw quadrant in humans. (A,B) ED 40–42. The earlier fusion between the medial nasal (mn) and maxillary (mx) processes is clearly apparent (dotted line). A narrow groove (arrowhead) separates the two thickenings of dental epithelium (DE), originating separately from the mn and mx. (C,D) ED 42–44. The DE forms a continuous dental mound. The former fusion between the facial processes (dotted line), including the fusion site on the dental mound (arrowhead), can still be traced. (E) Prenatal week 8. One can see primordia of the deciduous central incisor (i1), lateral incisor (i2), canine (c), and first molar (m1). The mesial part of the i1 has been cut out on 3D to show the shape of the dental and vestibular (VE) epithelia on the section. A shallow furrow on the germ of i2 (arrowhead) suggests the fusion site between the dental epithelia of two origins. The location of the fusion of the mn and mx processes is also detectable in the VE (double arrowhead). An asterisk determines the mouth corner. The midline is shaded. (pc) primitive choana. (F) An insert shows a scheme of the 3D reconstruction of the oral epithelium (OE) and the dental epithelium (DE). It is possible to see the mesenchyme-facing surface of the epithelium (MSE), because the mesenchyme itself was not included in the 3D reconstruction. The shape of tissues on a frontal section is shown in grey. BM, basement membrane.

 
ED 40–42
The medial nasal and maxillary processes were already fused. Two thickenings of the dental epithelium were apparent, originating independently from the medial nasal and maxillary processes. These two dental thickenings, in an end-to-end orientation, were separated by a narrow groove. A line of fusion between the former facial processes was clearly detectable on 3D reconstructions. It was formed by a furrow going from the primary choana in the antero-lateral direction through the groove in the thickened dental epithelium, and further anteriorly to the epithelium of the oral vestibule (Figs. 2A, 2BGo; Appendix Figs. 4A, 4B).

ED 42–44
The place of the earlier junction between the facial processes was still easily visible (Figs. 2C, 2DGo). It was formed by an oblique ridge between the primary choana and dental epithelium, and by a furrow continuing from the dental epithelium in the antero-medial direction to the epithelium of the oral vestibule. The dental epithelium formed a continuous dental mound, with a clearly detectable fusion site between its two original components (Figs. 2C, 2DGo; Appendix Fig. 4C). In the developmentaly more advanced embryo, tooth primordia began to be visible. The fusion site of the dental epithelia was detectable as a furrow on the germ of the lateral incisor (Appendix Fig. 4D).

ED 44–46
The fusion site of the dental epithelia of the medial nasal and maxillary processes was detectable on the germ of the lateral incisor. The fusion line could also be detected in the prospective vestibular area (Appendix Figs. 4E, 4F).

Prenatal Week 8
The primordia of both deciduous incisors, canine and first molar, were apparent on the dental mound. A shallow furrow on the lateral incisor germ suggested the earlier fusion between the dental epithelia of the medial nasal and maxillary processes. This furrow continued into the vestibular epithelium (Fig. 2EGo; Appendix Figs. 5A, 6).

Beginning of the 3rd Month
At this stage, no evidence of the fusion process was found in either the dental or in the adjacent epithelia (Appendix Fig. 5B).


   DISCUSSION
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS & METHODS
 RESULTS
 DISCUSSION
REFERENCES
 
The human upper jaw arch is formed by the fusion of the paired medial nasal and maxillary processes. The frontonasal process (a developmental base of the medial nasal process) is formed by neural crest cells (NCC) derived from the mid- and forebrain regions in the mouse (Osumi-Yamashita et al., 1994). However, the first branchial arch (giving rise to the maxillary and mandibular processes) is populated by NCC from more caudal regions of the midbrain and the hindbrain in the rat (Imai et al., 1996). As the present results showed, the area of fusion of facial processes is where the upper lateral incisor germ develops. Accordingly, this germ could be populated by NCC of two different origins. However, verification of the NCC contribution would require an in vitro experiment with cell markers, which cannot be performed in human embryos.

The present study focused on the origin of the epithelial component of the upper lateral incisor germ. We used a natural marker—the furrow at the previous fusion site between medial nasal and maxillary processes. This furrow could be traced up to prenatal week 8 (Fig. 2Go; Appendix Figs. 4, 5, 6). This marker allowed us to detect the epithelial contributions of the medial nasal and maxillary processes in the lateral incisor germ.

In humans, a thickened odontogenic epithelium can be identified in the 5th embryonic week on all the medial nasal and maxillary processes before their fusion (Ooë, 1957). The fusion of all components of the facial processes does not occur simultaneously. In macaques, the obliteration of the groove between the facial processes lags behind in the alveolus, compared with that in the lip (Wei et al., 2000). Generally, it is believed that the fusion of the human frontonasal, maxillary, and mandibular processes is complete by ED 38 (Tonge, 1967). The 3D reconstructions performed here clearly documented the fusion site between the medial nasal and maxillary processes. Although the facial processes proper have been fused, the thickenings of the dental epithelium were still separate at ED 40–42 (Figs. 2A, 2BGo; Appendix Figs. 4A, 4B). They fused as late as at ED 42–44 (Figs. 2C, 2DGo; Appendix Fig. 4C). Until prenatal week 8, the former fusion was indicated by a furrow on the lateral incisor germ that continued to the adjacent oral epithelia (Fig. 2EGo; Appendix Figs. 4D–4G, 5A, 6). Compared with the fusion of other components of the facial processes, the fusion of the dental epithelia was delayed (Figs. 1A–1EGo, 2A, 2BGo). The delay was estimated to be about 4–6 days.

At the fusion site of the facial processes, the germ of the upper lateral incisor emerged, comprised of epithelium from both the medial nasal and maxillary processes (Fig. 2Go; Appendix Fig. 4). Analysis of the present data, documenting the composite origin of the lateral incisor (Fig. 2Go; Appendix Figs. 4, 5, 6), fits with the observation that the original maxillary facial processes participate in the development of the premaxilla (Lisson and Kjaer, 1997; Barteczko and Jacob, 2004). On the premaxilla, the upper incisors erupt. In 1957, Ooë had already proposed, on the basis of his model of 3D reconstruction, that the human upper lateral incisor germ can have its origin partly in the medial nasal and partly in the maxillary process. By 3D reconstructions, a contribution of the maxillary process to incisor formation has also been demonstrated in the mouse (Peterkova et al., 1993). In the macaque, the developmental origin of the upper lateral incisor has been localized entirely on the maxillary process (Wei et al., 2000).

The complex origin of the human upper lateral deciduous incisor can explain its developmental vulnerability, resulting in anomalies of number, shape, and size, frequently associated with orofacial clefts (Böhn, 1963; Hansen and Mehdinia, 2002). The presumed double origin of the upper lateral incisor (Ooë, 1957) has been used to explain the high incidence of two lateral incisors adjacent to the cleft, mesially and distally, in patients with a complete cleft lip and palate (CLP) (Tsai et al., 1998) (Figs. 1FGo, 3AGo). The CLP formation is caused by the non-fusion of the medial nasal and maxillary processes, resulting from their insufficient development (hypoplasia) (Ferguson, 1991). We suggest that the non-fusion of the facial processes leads to the non-fusion of the two components of the lateral incisor (Figs. 1C, 1FGo). Their separate development may finally give rise to two lateral incisors, one on each side of the cleft (Figs. 1FGo, 3AGo).


Figure 3
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  		Figure 3. Double lateral incisors in patients after surgical treatment of an orofacial cleft. (A) Double deciduous lateral incisors in a patient with a left-sided alveolar cleft. (B) Double deciduous lateral incisors in a patient with a left-sided cleft lip with an intact jaw (left central incisor is missing). (C) Double permanent lateral incisors in a patient with a left-sided cleft lip with an intact jaw. The midline is shaded. Arrow points to the double lateral incisors. Deciduous central incisor (i1), permanent central incisor (I1), deciduous canine (c), permanent canine (PC) (from the archive of the Clinic of Plastic Surgery, Prague).

 
However, a supernumerary lateral incisor is also common in patients with an isolated cleft lip, who have an intact jaw without an alveolar cleft (Figs. 3B, 3CGo), or even in people having no orofacial cleft (Ravn, 1971; Jarvinen and Lehtinen, 1981). These cases can be explained by the incomplete fusion of the facial processes: The medial nasal and maxillary processes fuse except for their dental epithelia, which remain separate (Fig. 1EGo). From this aspect, the duplicated upper lateral incisor in an intact jaw might hypothetically be considered as a form of cleft arising during the latest phase of fusion of facial processes. An incomplete fusion of the two dental components could also give rise to rare dental anomalies, such as fused or T-shaped incisors. From a clinical aspect, it is important that one consider the delay in fusion of the dental epithelia as part of the critical period of clefting.

Moreover, the patients with supernumerary lateral incisors in an intact jaw can be at increased risk to carry some genetic predisposition for orofacial clefts. The presence of a supernumerary lateral incisor in otherwise clinically normal individuals could be used as a marker of possible cleft predisposition. As a similar marker, the ultrasonographic detection of orbicularis oris muscle defects has been proposed (Martin et al., 2000).

Beside the supernumeraries, other dental anomalies can be observed in the lateral incisor region in cleft patients: one lateral incisor distal to the alveolar cleft, one lateral incisor mesial to the alveolar cleft, and the absence of a lateral incisor on the cleft side.

The above-mentioned anomalies may be within the same spectrum and may be ranked according to the degree of hypoplasia (tissue insufficiency) of the facial processes. In humans, the fusion of facial processes proceeds from deeper to superficial. As fusion fails earlier, the more relevant (deeper) orofacial cleft occurs. Accordingly, the failing development of one or both components of the lateral incisor can be expected in more relevant cleft types that also affect hard tissues (cleft lip and alveolar process, CLP). One small lateral incisor located mesial or lateral to the alveolar cleft can reflect development of only one component of the lateral incisor (on the less hypoplastic facial process), while the second component (on the more hypoplastic process) did not form. The absence of the lateral incisor can be explained by the hypoplasia of both facial processes, including both components of the lateral incisor. From this aspect, the absence of the lateral incisor mesially and/or distally to the cleft could be the marker of the tissue insufficiency of the corresponding medial nasal and/or maxillary process. In contrast, the supernumerary lateral incisor might be more often associated with those cleft forms affecting only soft tissues (isolated soft-tissue cleft lip).

The type of lateral incisor pattern could be used to subclassify patients with different forms of cleft into separate etiologic categories. The etiology of clefting according to the lateral incisor phenotype can be tested in families, specially in non-cleft siblings of cleft patients. The significantly higher frequency of dental anomalies has been found in the non-cleft siblings of cleft patients, compared with the control non-cleft group (Schroeder and Green, 1975). However, a precise ranking of patients into groups according to orofacial cleft type is necessary before the evaluation of the genetic background of this defect can proceed.


   ACKNOWLEDGMENTS
 
This work was supported by the Ministry of Education, Youth, and Sports of the Czech Republic (project COST B23.002), by the Grant Agency of the Czech Republic (GACR 304/05/2665), and by the Academy of Sciences of the Czech Republic (project AV0Z 50390512). We thank Professor J. Slipka for providing some of the human embryological material, MUDr. Ziva Mullerova, CSc, for photos of patients, and anonymous reviewers for their helpful comments.


   FOOTNOTES
 
A supplemental appendix to this article is published electronically only at http://www.dentalresearch.org.

Received September 23, 2004; Last revision September 1, 2005; Accepted October 3, 2005


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS & METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Barteczko K, Jacob M (2004). A re-evaluation of the premaxillary bone in humans. Anat Embryol (Berl) 207:417–437.[Medline]

Böhn A (1963). Dental anomalies in harelip and cleft palate. Acta Odontol Scand 21(Suppl 38):35–40.

Ferguson MVJ (1991). The orofacial region. In: Textbook of fetal and perinatal pathology. Wigglesworth JS, Singer DB, editors. Boston: Blackwell Scientific Publications, pp. 843–880.

Hansen K, Mehdinia M (2002). Isolated soft tissue cleft lip: the influence on the nasal cavity and supernumerary laterals. Cleft Palate Craniofac J 39:322–326.[ISI][Medline]

Hovorakova M, Lesot H, Peterka M, Peterkova R (2005). The developmental relationship between the deciduous dentition and the oral vestibule in human embryos. Anat Embryol (Berl) 209:303–313.[Medline]

Imai H, Osumi-Yamashita N, Ninomiya Y, Eto K (1996). Contribution of early-emigrating midbrain crest cells to the dental mesenchyme of mandibular molar teeth in rat embryos. Dev Biol 176:151–165.[ISI][Medline]

Jarvinen S, Lehtinen L (1981). Supernumerary and congenitally missing primary teeth in Finnish children. An epidemiologic study. Acta Odontol Scand 39:83–86.[ISI][Medline]

Jordan RE, Kraus BS, Neptune CM (1966). Dental abnormalities associated with cleft lip and/or palate. Cleft Palate J 3:22–55.[Medline]

Lesot H, Vonesch JL, Peterka M, Tureckova J, Peterkova R, Ruch JV (1996). Mouse molar morphogenesis revisited by three dimensional reconstruction. II. Spatial distribution of mitoses and apoptosis in cap to bell staged first and second upper molar teeth. Int J Dev Biol 40:1017–1031.[ISI][Medline]

Lisson JA, Kjaer I (1997). Location of alveolar clefts relative to the incisive fissure. Cleft Palate Craniofac J 34:292–296.[ISI][Medline]

Martin RA, Hunter V, Neufeld-Kaiser W, Flodman P, Spence MA, Furnas D, et al. (2000). Ultrasonographic detection of orbicularis oris defects in first degree relatives of isolated cleft lip patients. Am J Med Genet 90:155–161.[ISI][Medline]

Ooë T (1957). On the early development of human dental lamina. Okajimas Folia Anat Jpn 30:198–210.[Medline]

Osumi-Yamashita N, Ninomiya Y, Doi H, Eto K (1994). The contribution of both forebrain and midbrain crest cells to the mesenchyme in the frontonasal mass of mouse embryos. Dev Biol 164:409–419.[ISI][Medline]

Peterkova R, Peterka M, Vonesch JL, Ruch JV (1993). Multiple developmental origin of the upper incisor in mouse: histological and computer assisted 3-D-reconstructions studies. Int J Dev Biol 37:581–588.[ISI][Medline]

Ravn JJ (1971). Aplasia, supernumerary teeth and fused teeth in the primary dentition. An epidemiologic study. Scand J Dent Res 79:1–6.[Medline]

Schroeder DC, Green LJ (1975). Frequency of dental trait anomalies in cleft, sibling, and noncleft groups. J Dent Res 54:802–807.[Abstract/Free Full Text]

Stamatiou J, Symons AL (1991). Agenesis of the permanent lateral incisor: distribution, number and sites. J Clin Pediatr Dent 15:244–246.[Medline]

Tonge CH (1967) Identification of cell patterns in human tooth differentiation. J Dent Res 46:876–878.[Free Full Text]

Tsai TP, Huang CS, Huang CC, See LC (1998). Distribution patterns of primary and permanent dentition in children with unilateral complete cleft lip and palate. Cleft Palate Craniofac J 35:154–160.[ISI][Medline]

Wei X, Senders C, Owiti GO, Liu X, Wei ZN, Dillard-Telm L, et al. (2000). The origin and development of the upper lateral incisor and premaxilla in normal and cleft lip/palate monkeys induced with cyclophosphamide. Cleft Palate Craniofac J 37:571–583.[ISI][Medline]





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