Unilateral short root anomaly: an incidental finding on routine radiographic examination

Abstract

© BMJ Publishing Group Limited 2021. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION A 19year old female patient with the report of irregularly placed upper front teeth sought orthodontic treatment. Clinically,she exhibited an edge to edge incisal relationship and class III malocclusion. Panoramic radiograph revealed the presence of all teeth including four unerupted third molars. Teeth 16, 26 and 36 were restored due to dental caries. The periodontal and supporting tissues were found to be healthy. Due to suspicion of dental caries on teeth 11 and 12, an intraoral periapical radiograph (IOPA) was taken, which showed abnormally short and conical root with respect to tooth 11, along with welldefined radiopacity on the distoproximal aspect of tooth 11 suggestive of previous restoration. Thereafter, a detailed radiological examination was carried out using cone beam CT (CBCT) in order evaluate the shortrooted tooth, 2 sectional image obtained from the CBCT showed that total length of the tooth was 14.57 mm, crown length from incisal tip to cementoenamel junction (CEJ) was 10.18 mm and root length from CEJ to the tip of the root was 4.40 mm, (figure 1A–C). The labial alveolar bone concavity over tooth 11 appeared to be more pronounced as compared with the bone morphology of the adjacent tooth 21 (figure 1D,E). This finding suggests a possible developmental aetiology. On further evaluation, the patient stated no history of trauma or previous orthodontic treatment. Clinically, the crown of tooth 11 had the same size and morphology when compared with the unaffected tooth 21. This is in accordance with the literature on short root anomaly cases. The root is theoretically considered short when its crown–root ratio is more than 1:1. Tooth 11 did not exhibit any signs of mobility and tested positive for pulp sensibility. All these findings were suggestive of short root anomaly (SRA). SRA is a rare condition that is often allied with genetic predisposition and higher female predilection. The aetiology of SRA is mostly characterised as idiopathic. Other suggested aetiologies include congenital or developmental origin, 7 external influences like trauma, syndromes, chemotherapy and radiotherapy. Literature affirms that this condition always affects both the central incisors. On the contrary, the clinical report presented here displays a case of unilateral pattern of SRA. Additionally, the root length was considerably short in comparison to its bilateral counterpart. Based on the literature search, there is a dearth in reports exhibiting unilateral cases of SRA, which makes this report unique.