Double Teeth and Coexistent Anomalies: Examples From Continental Africa.

Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8915029 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1520-6300 (Electronic) Linking ISSN: 10420533 NLM ISO Abbreviation: Am J Hum Biol Subsets: MEDLINE

Publication: New York, NY : Wiley-Blackwell
Original Publication: New York, NY : Alan R. Liss, Inc., c1989-

Incisor*/abnormalities; Humans ; Africa South of the Sahara/epidemiology ; Prevalence ; Fused Teeth/epidemiology ; History, Ancient ; Male ; Female ; Adult ; Tooth Abnormalities/epidemiology ; Paleodontology

Objectives: Whether gemination or fusion, double teeth are rare worldwide, including Africa based on few published data. New cases from the continent are tallied, and anomalies potentially associated with double teeth are identified. These findings should interest a range of dental researchers.
Methods: The presence of double teeth was recorded in 97 modern and premodern North and sub-Saharan African samples (5631 inds.). They and coexistent anomalies are described relative to published examples. Prevalence was estimated as possible, using a Poisson model for 95% confidence intervals (CI).
Results: Three maxillary double teeth were identified: a primary left lateral incisor in a Nubian child (1938-1756 BC), permanent left central incisor in an adult Egyptian (3650-3500 BC), and permanent right central incisor in a modern (19th century) adult from Guinea. Each co-occurs, respectively, with a talon cusp, peg lateral incisor and, in the latter individual, second premolar crown variation with rotation, and third molar dens evaginatus. Double tooth prevalence is 0.048% (CI 0.001%-0.270%), with regional variation, in premodern, and 0.000% in modern North Africans. It is 0.000% for premodern and 0.048% for modern sub-Saharan Africans (0.008%-1.714%).
Conclusions: The double incisors are comparable to other global examples, indicative of common developmental processes during odontogenesis. Prevalence is lower than published modern rates, to suggest some exceptionality in Africans as reported earlier for other dental variants. Finally, though circumstantial, double teeth and accompanying anomalies may share an etiology. Continuing research overall, and in Africa specifically, will promote an improved understanding of double teeth formation and expression.
(© 2024 The Author(s). American Journal of Human Biology published by Wiley Periodicals LLC.)

Adeyemi, T. E. , G. O. Ewansiha , M. N. Adekoya , and M. M. Iya . 2023. “Bilateral 90° Rotation of Maxillary Second Premolar: A Rare Case Report in Nigeria and Review of Literature.” Journal of Paediatric Dental Research and Practice 4, no. 2: 65–69.
Aguiló, L. , J. L. Gandia , R. Cibrian , and M. Catala . 1999. “Primary Double Teeth. A Retrospective Clinical Study of Their Morphological Characteristics and Associated Anomalies.” International Journal of Paediatric Dentistry 9, no. 3: 175–183.
AlQahtani, S. J. 2009. Atlas of Human Tooth Development and Eruption. London: Queen Mary and Westfield College.
Bello, S. , W. Olatunbosun , J. Adeoye , A. Adebayo , and N. Ikimi . 2019. “Prevalence and Presentation of Hyperdontia in a Non‐syndromic, Mixed Nigerian Population.” Journal of Clinical and Experimental Dentistry 11, no. 10: e930.
Beltrán, V. , C. Leiva , I. Valdivia , M. Cantín , and R. Fuentes . 2013. “Geminación Dental en un Incisivo Central Mandibular Permanente: una Anomalía Dental Infrecuente.” International journal of odontostomatology 7, no. 1: 69–72.
Benazzi, S. , L. Buti , L. Franzo , O. Kullmer , O. Winzen , and G. Gruppioni . 2010. “Report of Three Fused Primary Human Teeth in an Archaeological Material.” International Journal of Osteoarchaeology 20, no. 4: 481–485.
Brook, A. H. 1970. “Double Teeth, A Retrospective Study of ‘geminated’ and ‘fused’ Teeth in Children.” British Dental Journal 129: 123–130.
Buikstra, J. E. , and D. H. Ubelaker . 1994. Standards for Data Collection From Human Skeletal Remains. Arkansas Archaeological Survey Research Series No. 44. Fayetteville: Arkansas Archaeological Survey.
Castelino, R. L. , S. G. Babu , and S. R. Shetty . 2015. “Synodontia of Permanent Mandibular Central and Lateral Incisor—A Rare Entity.” Balkan Military Medical Review 18: 1–3.
Chanchala, H. P. , and B. Nandlal . 2012. “Coexistent peg Shaped Mandibular Central Incisors Along With Maxillary Lateral Incisors‐A Rare Case.” International Journal of Oral and Maxillofacial Pathology 3, no. 1: 65–68.
Collina, F. , S. Conti , M. Menetti , L. Scheda , R. Sorrentino , and S. Benazzi . 2021. “The First Archaeological Case of Permanent Teeth Fusion in Europe.” International Journal of Osteoarchaeology 31, no. 3: 469–474.
Danish, G. , U. Hegde , P. Mull , and S. Nabeel . 2014. “Dental Cusps: Normal, Supernumerary and Cusp‐Like Structures—An Overview.” Journal of Orofacial Research 4, no. 3: 161–168.
Decaup, P. H. , E. Garot , and P. Rouas . 2021. “Prevalence of Talon Cusp: Systematic Literature Review, Meta‐Analysis and New Scoring System.” Archives of Oral Biology 125: 105112.
Escobar, V. , P. Michael Conneally , and C. Lopez . 1977. “The Dentition of the Queckchi Indians. Anthropological Aspects.” American Journal of Physical Anthropology 47, no. 3: 443–451.
Folayan, M. O. , M. Alade , A. Adeniyi , M. El Tantawi , and T. L. Finlayson . 2019. “Association Between Developmental Dental Anomalies, Early Childhood Caries and Oral Hygiene Status of 3–5‐Year‐Old Children in Ile‐Ife, Nigeria.” BMC Oral Health 20, no. 1: 1–7.
Forshaw, R. 2021. “The ‘Two Brothers’: Dental and Cranial Evidence Relating to Two Ancient Egyptian Mummies.” Canarias Arqueológica 22: 455–467.
Friedman, R. 2007. “The C‐Group Cemetery at Locality HK27C.” Sudan & Nubia 11: 57–62.
Friedman, R. F. 2008. “The Cemeteries of Hierakonpolis.” Archéo‐Nil 18, no. 1: 8–29.
Friedman, R. F. , A. Maish , A. G. Fahmy , J. C. Darnell , and E. D. Johnson . 1999. “Preliminary Report on Field Work at Hierakonpolis: 1996–1998.” Journal of the American Research Center in Egypt 36: 1–35.
Giudice, G. L. , V. Nigrone , A. Longo , and M. Cicciù . 2008. “Supernumerary and Supplemental Teeth: Case Report.” European Journal of Paediatric Dentistry 9, no. 2: 97–101.
Guttal, K. S. , V. G. Naikmasur , P. Bhargava , and R. J. Bathi . 2010. “Frequency of Developmental Dental Anomalies in the Indian Population.” European Journal of Dentistry 4, no. 3: 263–269.
Halcrow, S. E. , and N. Tayles . 2010. “Talon Cusp in a Deciduous Lateral Incisor From Prehistoric Southeast Asia.” International Journal of Osteoarchaeology 20, no. 2: 240–247.
Hattab, F. N. , O. M. Yassin , and K. S. Al‐Nimri . 1995. “Talon Cusp‐Clinical Significance and Management.” Quintessence International 26: 115–120.
Hernandez‐Guisado, J. M. , D. Torres‐Lagares , P. Infante‐Cossio , and J. L. Gutierrez‐Perez . 2002. “Dental Gemination: Report of Case.” Medicina Oral 7, no. 3: 231–236.
Hierakonpolis‐online. 2012–2024. “The Workers' cemetery – HK43.” Accessed April 26, 2024. http://www.hierakonpolis‐online.org/index.php/explore‐the‐predynastic‐cemeteries/hk43‐workers‐cemetery.
Hillson, S. 2023. Dental Anthropology. Second ed. Cambridge: Cambridge University Press.
Hunasgi, S. , A. Koneru , V. Manvikar , M. Vanishree , and R. Amrutha . 2017. “A Rare Case of Twinning Involving Primary Maxillary Lateral Incisor With Review of Literature.” Journal of Clinical and Diagnostic Research: JCDR 11, no. 2: ZD09–ZD11.
Irish, J. D. 1997. “Characteristic High‐and Low‐Frequency Dental Traits in sub‐Saharan African Populations.” American Journal of Physical Anthropology 102, no. 4: 455–467.
Irish, J. D. 1998. “Dental Morphological Affinities of Late Pleistocene Through Recent Sub‐Saharan and North African Peoples.” Bulletins et Memoires de la Societé d'Anthropologie de Paris. Nouvelle Serie 10: 237–272.
Irish, J. D. 2000. “The Iberomaurusian Enigma: North African Progenitor or Dead end?” Journal of Human Evolution 39, no. 4: 393–410.
Irish, J. D. 2006. “Who Were the Ancient Egyptians? Dental Affinities Among Neolithic Through Postdynastic Peoples.” American Journal of Physical Anthropology 129, no. 4: 529–543.
Irish, J. D. 2013. “Afridonty: The “sub‐Saharan African Dental Complex” Revisited.” In Anthropological Perspectives on Tooth Morphology: Genetics, Evolution, Variation, edited by G. R. Scott and J. D. Irish , 278–295. Cambridge: Cambridge University Press.
Irish, J. D. 2016. “Who Were They Really? Model‐Free and Model‐Bound Dental Nonmetric Analyses to Affirm Documented Population Affiliations of Seven South African “Bantu” Samples.” American Journal of Physical Anthropology 159, no. 4: 655–670.
Irish, J. D. 2017. “Knocking, Filing, and Chipping: Dental Modification in Sub‐Saharan Africans.” In A World View of Bioculturally Modified Teeth, edited by S. E. Burnett and J. D. Irish , 33–47. Gainesville: University Press of Florida.
Irish, J. D. 2020. “Tooth Transposition Prevalence and Type Among Sub‐Saharan Africans.” American Journal of Human Biology 32, no. 2: e23329.
Irish, J. D. 2022. “Hyperdontia Across Sub‐Saharan Africa: Prevalence, Patterning, and Implications.” Archives of Oral Biology 140: 105463.
Irish, J. D. 2024. “Agenesis of the Permanent Teeth in Sub‐Saharan Africans: Prevalence, Patterns, Interpretations.” Archives of Oral Biology 162: 105961.
Knežević, A. , S. Travan , Z. Tarle , J. Šutalo , B. Janković , and I. Ciglar . 2002. “Double Tooth.” Collegium Antropologicum 26, no. 2: 667–672.
Kocsis, G. , A. Marcsik , E. Kokai , and K. Kocsis . 2002. “Supernumerary Occlusal Cusps on Permanent Human Teeth.” Acta Biologica Szegediensis 46, no. 1–2: 71–82.
Kondo, S. , G. Townsend , and M. Matsuno . 2014. “Morphological Variation of the Maxillary Lateral Incisor.” Japanese Dental Science Review 50, no. 4: 100–107.
Koszowski, R. , J. Waśkowska , G. Kucharski , and J. Śmieszek‐Wilczewska . 2014. “Double Teeth: Evaluation of 10‐Years of Clinical Material.” Open Medicine 9, no. 2: 254–263.
Lau, T. 1955. “Odontomes of the Axial Core Type.” British Dental Journal 99: 219–225.
Lee, C. K. , N. M. King , E. C. M. Lo , and S. Y. Cho . 2007. “The Relationship Between a Primary Maxillary Incisor With a Talon Cusp and the Permanent Successor: A Study of 57 Cases.” International Journal of Paediatric Dentistry 17, no. 3: 178–185.
Levitan, M. E. , and V. T. Himel . 2006. “Dens Evaginatus: Literature Review, Pathophysiology, and Comprehensive Treatment Regimen.” Journal of Endodontics 32, no. 1: 1–9.
Lomçali, G. , S. Hazar , and H. Altinbulak . 1994. “Talon Cusp: Report of Five Cases.” Quintessence International 25, no. 6: 431–448.
Marra, P. M. , L. Nucci , L. Femiano , V. Grassia , L. Nastri , and L. Perillo . 2020. “Orthodontic Management of a Mandibular Double‐Tooth Incisor: A Case Report.” Open Dentistry Journal 14, no. 1: 219–225.
Mays, S. 2005. “Talon Cusp in a Primary Lateral Incisor From a Medieval Child.” International Journal of Paediatric Dentistry 15, no. 1: 67–72.
McMullan, R. E. , and E. Kvam . 1990. “Investigation of Premolar Rotation in a Group of 15‐Year‐Old Norwegian Children.” European Journal of Orthodontics 12, no. 3: 311–315.
Milazzo, A. , and S. A. Alexander . 1982. “Fusion, Gemination, Oligodontia, and Taurodontism.” Journal of Pedodontics 6, no. 2: 194–199.
Murray, M. A. 1910. The Tomb of Two Brothers. Vol. 68. Manchester: Sherratt & Hughes.
Nagaveni, N. B. , and K. V. Umashankara . 2013. “Maxillary Molar With Dens Evaginatus and Multiple Cusps: Report of a Rare Case and Literature Review.” International Journal of Oral Health Sciences 3, no. 2: 92–97.
Nayak, G. , and I. Singh . 2013. “A Variation in Tooth Position‐180 Rotated Maxillary Second Premolar.” Journal of Clinical and Diagnostic Research: JCDR 7, no. 8: 1806–1807.
Onyeaso, C. O. , and A. O. Oneyeaso . 2006. “Occlusal/Dental Anomalies Found in a Random Sample of Nigerian Schoolchildren.” Oral Health & Preventive Dentistry 4, no. 3: 181–186.
Ooshima, T. , R. Ishida , K. Mishima , and S. Sobue . 1996. “The Prevalence of Developmental Anomalies of Teeth and Their Association With Tooth Size in the Primary and Permanent Dentitions of 1650 Japanese Children.” International Journal of Paediatric Dentistry 6: 87–94.
Padgett, B. D. 2010. “Triple Fusion in the Primary Dentition From Law's Site, Alabama (1MS100): A Case Report.” Dental Anthropology Journal 23, no. 1: 25–27.
Phillips, E. L. , J. D. Irish , and D. Antoine . 2021. “Ancient Anomalies: Twinned and Supernumerary Incisors in a Medieval Nubian.” International Journal of Osteoarchaeology 31, no. 3: 456–461.
Pindborg, J. J. 1970. Pathology of the Dental Hard Tissues. Copenhagen: Munksgaaed.
Rajashekhara, B. S. , B. Dave , B. S. Manjunatha , K. S. Poonacha , and S. Sujan . 2010. “Bilateral Fusion of Primary Mandibular Lateral Incisors and Canines: A Report of a Rare Case.” Revista Odonto Ciencia 25, no. 4: 427–429.
Ramamurthy, S. , R. Satish , and K. Priya . 2014. “Surgical and Orthodontic Management of Fused Maxillary Central and Lateral Incisors in Early Mixed Dentition Stage.” Case Reports in Dentistry 2014: 1–4.
Rantanen, A. V. 1971. “Talon Cusp.” Oral Surgery, Oral Medicine, and Oral Pathology 32: 398–400.
Rothman, K. J. , S. Greenland , and T. L. Lash . 2008. Modern Epidemiology. Vol. 3. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Ruffer, S. A. 1920. “Study of Abnormalities and Pathology of Ancient Egyptian Teeth.” American Journal of Physical Anthropology 3, no. 3: 335–382.
Rushman, H. , and R. Meon . 1991. “Talon Cusp in Malaysia.” Australian Dental Journal 36: 11–14.
Santos, L. M. , F. D. S. Forte , and M. J. C. Rocha . 2003. “Pulp Therapy in a Maxillary Fused Primary Central Incisor–Report of a Case.” International Journal of Paediatric Dentistry 13, no. 4: 274–278.
Šarkić, N. , S. Moreno , I. Erjavec , J. Herrerin , and L. González‐Garrido . 2022. “A Micro‐Computed Tomography Examination of Primary Double Teeth From the Muslim Necropolis of Macael Viejo (13th–16th Centuries; Almeria, Spain).” Journal of Bioanthropology 2, no. 2: 6–13.
Scheid, R. C. 2007. Woelfel’s Dental Anatomy: Its Relevance to Dentistry. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins.
Schulze, C. 1987. Anomalien und Missbildungen der menschlichen Zähne. Berlin: Die Quintessenz.
Scott, G. R. , and J. D. Irish . 2017. Human Tooth Crown and Root Morphology: The Arizona State University Dental Anthropology System. Cambridge: Cambridge University Press.
Shokri, A. , M. Baharvand , and H. Mortazavi . 2013. “The Largest Bilateral Gemination of Permanent Maxillary Central Incisors: Report of a Case.” Journal of Clinical and Experimental Dentistry 5, no. 5: e295.
Silva, A. M. , and A. C. Subtil . 2009. “Talon Cusp in a Deciduous Upper Incisor From a Medieval Portuguese Child.” Anthropological Science 117: 45–49.
Sperduti, A. , L. Fattore , M. Botto , et al. 2021. “Dental Twinning in the Primary Dentition: New Archaeological Cases From Italy.” Bulletin Of The International Association For Paleodontology 15, no. 1: 6–20.
Stefan, V. H. 2006. “Brief Communication: Rotation of the Maxillary Premolars: Evidence in Support of Premolar Morphogenetic Field.” Dental Anthropology Journal 19, no. 3: 70–73.
Suresh, K. V. , C. Y. Zhong , and S. Yadav . 2020. “Bilateral 180 Rotated Maxillary Second Premolars: A Rare Case Report.” Journal of Datta Meghe Institute of Medical Sciences University 15, no. 4: 662–664.
Tannenbaum, K. A. , and E. E. Alling . 1963. “Anomalous Tooth Development: Case Reports of Gemination and Twinning.” Oral Surgery 18: 883–887.
Temilola, D. O. , M. O. Folayan , O. Fatusi , et al. 2014. “The Prevalence, Pattern and Clinical Presentation of Developmental Dental Hard‐Tissue Anomalies in Children With Primary and mix Dentition From Ile‐Ife, Nigeria.” BMC Oral Health 14: 1–8.
Türkaslan, S. , H. S. Gökçe , and M. Dalkız . 2007. “Esthetic Rehabilitation of Bilateral Geminated Teeth: A Case Report.” European Journal of Dentistry 1, no. 3: 188–191.
Wu, L. , B. Shi , R. Zhang , and J. Liu . 2019. “Case Report Root Canal Therapy of a Supernumerary Tooth Fused With Maxillary Second Molar: A Case Report.” International Journal of Clinical and Experimental Medicine 12, no. 4: 4422–4427.

Graduate College, Arizona State University; American Museum of Natural History; Friends of Nekhen; Institute of Archaeology and Ethnology-Polish Academy of Sciences; BNS-9013942 National Science Foundation; BNS-0104731 National Science Foundation; BCS-0840674 National Science Foundation; BCS-0119754 National Science Foundation; Institute for Bioarchaeology; 2017/25/B/HS3/03928 National Science Centre

Keywords: dens evaginatus; double teeth; fusion; gemination; talon cusp

Date Created: 20240903 Date Completed: 20241107 Latest Revision: 20241107

20241107

10.1002/ajhb.24149

39224001