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The first article described history, aetiology, molecular signalling mechanism, epidemiology and classification of taurodontism. This final article of the two-part series focuses on the biomechanics and other clinical aspects of taurodontism.
In certain disorders, especially during initial stages, the teeth can appear taurodontic and may complicate diagnosis. These conditions, along with their key features, are highlighted in this article, as are several syndromes relevant to taurodontism. In addition, the sections on imaging and clinical considerations discuss diagnostic methods and management of taurodontic teeth, respectively. Taurodontism, especially in severe forms, can be a root canal challenge. Sometimes, multiple taurodontism is seen in association with various syndromes and perhaps may assist in early diagnosis.
CPD/Clinical Relevance: Taurodontism has clinical implications in various dental disciplines, such as endodontics, surgery, orthodontics and prosthodontics. However, it is most relevant to endodontists as this deviation exclusively affects the internal anatomy of teeth.
Article
The second article of this two-part series aims to review the biomechanics of taurodontic teeth, their diagnostic considerations, relevant syndromes, imaging methods, clinical management and prognosis. The hallmarks of taurodontism are:
Taurodontism can occur in isolation, or in multiple teeth, unilaterally or bilaterally, in a normal population or associated with syndromes with a varying degree of severity (Figure 1).2 It is most commonly found in molars, followed by premolars and mandibular anterior teeth.3
Recent research studied the biomechanics of taurodonts on digital models of Neanderthal specimen ‘Le Moustier 1’. This study was conducted to help understand the reasons behind high frequency of taurodontism found in Neanderthals. To evaluate this, four hypotheses were projected as possible factors responsible for taurodontism:
In this experiment, finite element analysis (FEA) and other advanced loading methods were used. The digital models of lower right first molar (RM1), along with reduced and hypertaurodontic models of RM1 of Neandertal specimen ‘Le Moustier 1’ were subjected to loading conditions. In addition, a simulated test was performed to evaluate para-masticatory efficiency of taurodontic teeth. In this test, an object was placed between teeth and pulled in various directions. The results from simulated tests did not reveal any significant biomechanical advantage of taurodontic teeth during para-masticatory function and, hence, rejected the biomechanical hypothesis. The authors of this study concluded that the high frequency of taurodontic teeth in Neanderthals most probably had evolved as an adaptive mechanism to high attrition diet routine or due to pleiotropic effects.4 It could also be a result of genetic drift and bottleneck effects, consequently elucidating the limited morphological discrepancy observed in Neanderthals.
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