Taurodontism Part 1: History, Aetiology and Molecular Signalling, Epidemiology and

Classification
Hasan M. Dental Update 2019

Introduction and Nomenclature

 Derived from Latin “Tauros” and Greek “Odonto”
 Characterised by teeth lacking cervical constriction at the amelocementary
junction with vertically enlarged pulp chambers, apical displacement of furcation
and short roots
Historical Background
 Observed in the fossil remains belonging to the Neanderthal hominids discovered
in 1899 in Croatia (the Ice Age)
 Neanderthals, a now extinct group of fossil hominins, were widespread across
Europe from 200,000 util around 35,500 years ago
 All known to have taurodont molar teeth
 70,000 year old anthropological specimen belonging to the Krapina Neanderthals
that shows taurodontism
  this anomaly a characteristic of a primitive pattern
The study on a specimen found in Qesem Cave
 An anthropological specimen of a deciduous second molar was found in Qesem
Cave (QC) Middle Pleistocene hominin site in Israel
 The site is associated with the Acheulo-Yabrudian Cultural Complex (dated to
about 420,000 − 220,000 years ago).
 Fornai et al used various methods to understand the inner and outer morphology
of this deciduous second molar
 The deciduous second molar specimen showed:
o thinner enamel
o large size with hypotaurodontism
o midtrigonoid crest
o mesio-distal elongation of the enamel dentine junction
o mild crown expansion on the distal side
 The deciduous second molar specimen close to the Neanderthals, while present
day humans also share some of its features
Mechanism of Root Formation
The Aetiology of Taurodontism
 Conventional belief: Delayed or failed invagination of the diaphragm of Hertwig’s
epithelial root sheath  formation of short roots, enlarged pulp cavities and lack
of cervical constriction

Molecular Signalling and Taurodontism

 The signalling mechanisms that trigger this delay or failure are unknown
 Possibily associated with a signalling molecule Wnt10a
 Involved root formation, when expressed in cells of dental papilla (mature
odontoblasts and mesenchymals cells).
 Defects in this signalling molecule might lead to a delayed or failed
invagination of HHERS
 Yang et al., researched the function of Wnt10a which could be responsible for
 tooth agenesis, malformed crowns and taurodontism
 The authors observed the following dental phenotype in Wnt10a null mice:
 Supernumerary teeth (mandibular fourth molars);
 Predisposition to root resorption
 Short roots (taurodontism)
 Mis-shaped crowns
 Small molar crown
 Pulp stones
 In six human families with nonsyndromic tooth agenesis, the following Wnt10a
defects were noted
 Taurodontism
 Malformed molar crowns
 Pulp stones (only in one family
  The signalling molecule, Wnt10a, plays an important role in furcation and root
formation, especially of multi-rooted teeth
Prevalence
 Rare, but global prevalence ranges from 0.1 to 60%
o wide range is probably due to disparities between various population
groups and different diagnositic standards
 Frequently seen in natives of Central America, Australia and Alaska
 Seen primarily in permanent teeth
 Mandibular molars > Maxillary molars and premolars
o But debatable, a study showed permanent maxillary second molars have
the highest prevalence
 Several studies show MEN = WOMEN
o But a study carried out on a German population showed women > men but
not statistically significant.
o One Chinese study has shown taurodontism to be more prevalent in
women
Classification
 Taurodonts are sub-classified based on their degree of pulpal floor displacement
towards the apex
 A cynodont is a normal tooth
 Developed to indicate the severity of taurodontism through a quantitative
radiographic assessment (Keene  modified by Shifman and Chanannel)
 V1/V2 x 100 = TI severity (%)
 V1 = height of the pulpal cavity
 V2 roof of the pulp cavity to the longest apex
 If the value > 20%, taurodontism is present
  Taurodontism Index Values
 Measure the arbitrary distance from the highest end of the pulp cavity to the
CEJ (V3)
 Shifman and Chanannel suggested that V3 > 2.5mm
 The ratio from the height of the pulp cavity to the distance between pulpal
roof and longest root apex should be at least 0.2

 Modification to the original Taurodontism Index (TI)

o 1928, Shaw Index – External morphology measuring crown body to root
ratio (CB:R) (not used anymore)
o 1966, Keene index internal morphology - Did not consider age related
changes in tooth structure
o 1978, Shifman and Chanannel index – Improved but does not consider:
 Variations in root lengths (sex, ethnicity)
 Changes in root length due to resorption
 Short roots due to immature development
Summary
 Taurodontism can occur in both maxillary and mandibular teeth, especially
permanent molars
 Chance finding during radiographic examination
 Based on the literature review, it does not have a gender predilection
 Possible role of the Wnt10a molecule in the development of taurodontism