Rosette formation of impacted molar teeth in mucopolysaccharidoses and related disorders

The radiographic features of the jaws in the mucopolysaccharidoses and related disorders (MPS) have been reviewed and three further cases are reported here, with particular reference to a novel dental anomaly, not previously described in detail, in two of them. The dental changes appear to be fully developed by the third decade and are characterized by bilateral multiple impacted molar teeth, which conglomerate in a single follicle to form a characteristic rosette of teeth. Rosetting was present only in relatively mature cases of MPS. However, it was also seen in the fourth patient, where we could not detect any other abnormal clinical or radiographic features. We therefore propose that since multiple rosetting of molar teeth can also occur in an isolated form, it is only suggestive of MPS.