469 - Management Outcomes of Leong’s Premolars – A Clinical Audit

Saturday, May 28, 2022

1:20 PM – 1:35 PM PT

Location: Sails Pavilion

Has Audio

Presenting Author(s)

DC

Doris Chua, BDS, MDS

Registrar
National Dental Centre Singapore
Singapore, Singapore

Co-Author(s)

WT

Wee Kiat Tan, BDS, MDS

Senior Consultant
National Dental Centre
National Dental Centre Singapore
Singapore, Singapore

Research Mentor(s)

WT

Wee Kiat Tan, BDS, MDS

Senior Consultant
National Dental Centre
National Dental Centre Singapore
Singapore, Singapore

Program Director(s)

BL

Bien Lai, BDS, MS

Senior Consultant
National Dental Centre Singapore
Singapore, Singapore

Purpose:

Dens Evaginatus in permanent premolars, also called Leong's Premolars (LPs), are a common dental anomaly in the Mongoloid population. This clinical audit assessed management outcomes of LPs at a tertiary dental centre.

Methods:

Dental records of patients aged 8-16 years seen from 2017-2019, with the codes “Dens Evaginatus”, “Revascularisation/apexification” or “Root canal treatment” were retrieved from the database at the National Dental Centre Singapore. Cases of dens evaginatus or pulp therapy of teeth other than premolars were excluded. Data on symptoms, management and outcomes were collected.

Results:

Thirty-nine individuals (94.9% Chinese) with mean age 11.6 years at detection, presented with 109 LPs. Seventy-eight (71.6%) of LPs were asymptomatic. Twenty-six of these received no treatment; three remained asymptomatic while 23 failed to follow up. Forty asymptomatic LPs underwent preventive tubercle reinforcement; 77.5% remained asymptomatic and 22.5% failed to follow up.

Adverse symptoms (pain, abscess, facial cellulitis) were reported in 28.4% of LPs. 77.4% of symptomatic LPs were successfully treated (with root canal treatment or regenerative endodontics) while 22.6% failed to follow up after treatment had commenced.

Seven LPs required treatment following failure of the first treatment, including 3 which had undergone regenerative endodontics. Mean number of visits for regenerative endodontics was 4.4.

Conclusions:

The audit highlighted inadequate follow-up of LPs which may contribute to an under-reporting of their negative management outcomes. Regenerative endodontics of LPs should not be considered foolproof. Early identification and timely preventive procedures should be primary objectives of LP management.