Evaluation of the Relationship between Gubernaculum Dentis and Tooth Development with Cone Beam Computed Tomography

Lale Rizeli and Ayşe Zeynep Zengin*

Aim: The Gubernaculum Dentis (GD) is a structure that serves as the eruption path for permanent teeth, extending from the tooth follicle to the gingiva and including the gubernacular cord. It plays a crucial role in the normal eruption process by providing a defined path for the tooth to emerge through the bone. Radiographically, GD is visible as a radiolucent area, bordered by cortical bone, around the crown of an unerupted tooth on standard X-rays. On Cone Beam Computed Tomography (CBCT) scans, it appears as a hypodense cortical path adjacent to the dental follicle of the unerupted tooth.

This study aims to examine the prevalence, radiological appearance, and characteristics of GD in unerupted permanent teeth with CBCT and to investigate its characteristics according to the Demirjian dental calcification scale. 

Materials and methods: Radiographic images of 75 pediatric patients whose CBCT images were taken for various reasons were analysed retrospectively. The prevalence of GD in the images, types of shapes, attachment sites to the teeth, and areas of openings in the alveolar crest were evaluated. GD angle and length measurements were made on CBCT images. Teeth were classified according to Demirjian tooth development method and the relationship between GD and tooth development was examined. 

Results: The prevalence of GD was found as 73.5% in the 1055 unerupted teeth that were examined. While the prevalence of GD was 60% in the maxilla, it was found as 87.8% in the mandible. (p < 0.001) When the shapes of GDs were analyzed, the most common shape was flat with 54.8%, followed by rectangular with 38.7%. When the opening sites of teeth with GD were examined, the highest rate was found in palatinal and lingual with 57.8%, followed by the crest apex with 40.9%. The mean GD angle was found as 6.260, while the mean length was found as 3.93 mm. According to the Demirjian tooth calcification scale, the highest rate of GD was seen in stage C teeth with 92.7%, while the lowest rate of GD was seen in stage A teeth with 33.3% (p < 0.001). 

Conclusion: According to the results of this study, it was found that GD was mostly in the maxilla and flat. GD length value was found to be higher in the mandibular teeth, Demirjian scale A and especially canine teeth.

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Published on: Dec 6, 2024 Pages: 9-16

Full Text PDF Full Text HTML DOI: 10.17352/2455-4634.000064
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