Volume 3, Issue 1 US $6.00

Editor:

Allan G. Farman, BDS, PhD(odont.), DSc (odont.),Diplomate of theAmerican Board of Oraland MaxillofacialRadiology, Professor ofRadiology and ImagingSciences, Department ofSurgical and HospitalDentistry, The University ofLouisville School ofDentistry, Louisville, KY.

Featured Article:

Panoramic radiologicappraisal of anomalies ofdentition: Chapter #1

In The Recent Literature:

Canine ectopia

Dental age assessment

Impacted third molars

Second molar eruptionpatterns

By Dr. Allan G. Farman

Panoramic radiologic appraisal ofanomalies of dentition: Chapter #1

Following FDA guidelines forradiographic examinations, theAmerican Academy of PediatricDentistry in 1997 reaffirmed itsrecommendation for radiographicassessments of the dentition,growth and development duringthe transitional dentition and inadolescence.[1] This recommen-dation can be followed by mak-ing panoramic radiographs ofyour patients when they areapproximately 5-7, 9-12 and 16-18years old.

Whittington and Durward(1996) used panoramic radio-graphs to survey anomalies inprimary teeth and their correla-tion with the permanent dentitionof 1,680 5-year-old children.Anomalies of the primary teethwere detected in 23 children(1.4 %). Six children (3 boys and 3girls) had hypodontia, 3 children(2 boys and 1 girl) had a supernu-merary tooth, and 14 children (9boys and 5 girls) had connatedteeth. Six of the affected teeth(in 4 boys and 2 girls) were diag-nosed as fusion, and 8 (5 boys and3 girls) as gemination. The pan-oramic radiographs of the 23children with anomalies of theprimary teeth revealed that 14(61 %) also had anomalies of thesuccedaneous permanent teeth.Children with hypodontia in theprimary dentition all had corre-

sponding permanent teethmissing. The results of the studyconfirm that, when there ishypodontia, hyperdontia, gemi-nation, or fusion of teeth in theprimary dentition, there is anincreased likelihood of anomaliesof the succedaneous permanentteeth. Because of this closerelationship between the denti-tions, early identification ofanomalies of the primary teethcan allow the dentist to investi-gate further and plan for treat-ment at the appropriate time.

Locht (1980) evaluated pan-oramic radiographs of 704 Danishchildren aged 9-10 years andfound 631 malpositioned teeth,caries in 224 primary and 32permanent teeth, 60 malformedpermanent teeth, 53 periapicalinflammatory radiolucencies, and42 dentigerous cysts. Hypodontiawas present in 7.7 % and supernu-meraries in 1.7 % of the studiedpopulation. These radiographicfindings were certainly importantfor dental treatment planning.[3]Neal and Bowden (1988) alsoexamine the diagnostic valueobtained from panoramic radio-graphs taken at 9-10 years ofage.[4] Radiographs from 982patients were examined and 261(26.5 %) showed findings ofsignificance in orthodonticdiagnosis and treatment planning.

Cholitgul and Drummond(2000) examined panoramic

In order to provide more extensive coverage to our clinical topics,Panoramic Imaging News has been expanded to eight pages.With this issue, we begin a multiple part series focusing ondevelopmental anomalies of the dentition.

22222

“ Early detection of dental anomalies allows for timely intervention.Failure to achieve timely detection often results in more extensivetreatment combined with a poorer outcome prognosis.”

radiographs of 1,608 children andadolescents aged 10 to 15 years(797 males and 811 females) todetermine the prevalence oftooth and jaw abnormalities.Abnormalities were detected in21 % of the radiographs (23 % offemales and 17 % of males); 879teeth were diagnosed withabnormalities on 331 radiographs.The most common abnormalitieswere malpositioned teeth, missingteeth, misshaped teeth, andteeth appearing hypoplastic.Bony abnormalities and growthproblems were also detected.This study demonstrated thevalue of panoramic radiographyin detecting or confirming dentalabnormalities, and supports the

use of panoramic radiography toaid in the assessment of dentaldevelopment.

Early detection of dentalanomalies allows for timelyintervention. Failure to achievetimely detection often results inmore extensive treatment com-bined with a poorer outcomeprognosis. Making a panoramicradiograph at the appropriatetime is a matter of professional-ism. Failure to do so might wellconstitute professional negli-gence.

Teeth develop in utero andduring the first two decades afterbirth, with maturation and regres-sive changes occurring through-out life. It is important to under-

stand the biological se-quence and range in toothdevelopment if one is toadequately assess anoma-lous dental developmentsand their clinical conse-quences. The reader’s knowl-edge of normal developmen-tal stages will be assumed forthe purpose of this article.

Development anomaliesof the dentition can dedivided according to thestage of tooth formationwhen the abnormality isinitiated. Stages of toothdevelopment (Fig. 1) start withinitiation of tooth formationby ectomesenchymal stimu-lation and subsequent prolif-eration of the overlyingepithelium to form first thedental lamina and subse-quently the tooth bud.

Fig. 1. Stages of development intooth development. The type ofdevelopmental anomaly is largelydictated by the stage at which itis initiated.

33333

Abnormalities in the numberof teeth can be caused by afailure in tooth bud formation(too few teeth) or formationof an excess number of toothbuds (too many teeth). This isfollowed by stages ofhistodifferentiation andmorphodifferentiation.Anomalies in tooth shapelikely occur during one or bothof these stages. The develop-ing tooth next moves to thestage of mineralization.Anomalies in structure of themineralized tissues can occurat this stage. Mineralization ofthe crown is followed by tootheruption that can also beaberrant causing dentalimpaction, malocclusion,transposition or ectopia.Maturation includes thecompletion of the toothroot(s) (normally three yearsfollowing eruption for perma-nent teeth), and subsequentincreasing thickness of thedentin surrounding the pulp.Mild attrition such as thewearing down of enamelmamelons on the incisiveedges of incisors can also beconsidered a process ofmaturation. More severeattrition, abrasion, erosion,dental caries, and exodontiascan be considered regressivechanges beyond the scope ofthis article.

A detailed review of alldental anomalies is too widea topic for a single issue ofthis newsletter. This issue willbegin to review abnormalitiesresulting in a reduction of thenumber of teeth. Variations indental morphology andstructure, impaction and

abnormal eruption will be sub-jects for subsequent issues.

Anomalies in tooth numberThe full human dentition is com-posed of 20 primary teeth (8incisors; 4 canines; 8 molars)followed by transition to 32 adultteeth (8 incisors; 4 canines; 8premolars; 12 molars) with equalnumbers of teeth in each jaw. Ifless than the normal complementof teeth develops, the patient issaid to have hypodontia. If apatient develops an excessivenumber of teeth, the extra teethare termed supernumeraries.Panoramic radiographs are ofparticular importance for evaluat-ing the number of teeth presentas they provide the whole picturerather than just small segments ofcoverage. Furthermore, bothregular and supernumerary teethmay be displaced to positions stillwithin the panoramic view butbeyond the bounds of a periapi-cal radiograph.

HypodontiaFor hypodontia to be diagnosed,the missing tooth or teeth mustnot be accounted for by extrac-tion. Dental extractions result in“pseudohypodontia.” Pseudonymsfor hypodontia are oligodontiaand “partial anodontia”. The latterterm, while still used in severaltexts, is a misuse of the Englishlanguage as it conditions anabsolute. Anodontia, the com-plete absence of teeth, canrarely occur in consequence ofthe several ectodermal dysplasiasyndromes, but is extremely rare.Large numbers of missing teeth,and teeth with stunted rootformation, can also be a compli-cation of radiation therapy

applied to treat childhoodcancers.

The most frequently missingpermanent teeth are the thirdmolars and maxillary lateralincisors, followed by thepremolars in either jaw. Whilemissing third molars rarely if evercause clinical problems, missingmaxillary lateral incisors havecosmetic consequences thatrequire working with the child’sparents or legal guardians toestablish a treatment strategy ofspace maintenance plus pros-thetic replacement versus caninesubstitution. Similarly, missingpremolars require considerationof orthodontic consequences,planning space maintenance orclosure (Fig. 2). Where permanentteeth are absent there is often anassociated reduction in alveolarbone height and width, anddrifting of adjacent teeth. If theprimary tooth is retained, thereare several possible outcomes. Inthe case of the maxillary lateralincisor, the crown size is small andshort and its retention rarelyprovides a good cosmetic result.Crowning the primary tooth is notusually an option as the neck ofthe tooth is too narrow, and theroot has frequently been re-sorbed to a greater or lesserextent. In the case of the missingpremolar, the retained primarymolar has a crown height that ismuch shorter than that of theadjacent permanent molar. Theresulting malocclusion canpredispose to periodontal dis-ease and compromise the sur-vival of the adjacent tooth orteeth. Alternatively, the primarymolar may be ankylosed (fused)for the underlying bone. In suchcases, normal growth and devel-

44444

Fig. 2. Hypodontia with missing second mandibular premolar teeth and retained primarysecond molars. Each example shows a different clinical outcome. From upper left to lowerright the cases show: (a) slight root resorption of retained primary and some tilting of adjacentpermanent teeth; (b) marked root resorption of primary molar; (c) root resorption with bonyankylosis of retained primary molar; (d) re-submergence of retained primary tooth; (e) severeperiodontal disease affecting adjacent regular teeth.

opment can causeresubmergence of the retainedprimary tooth. One can onlysurmise the difficulty that anorthodontist would have if anattempt were made to move apermanent tooth through such asubmerged primary.

Ith-Hansen and Kjaer investi-gated persistent primary secondmolars in a group of young

people in their late twenties withagenesis of one or two secondpremolars [6]. In 1982-83 it hadbeen decided, in connection withthe orthodontic evaluation of 25patients, to allow 35 primarymolars (one or two in each pa-tient) to remain in situ. All patientshad mixed dentitions and agen-esis of one or two premolars. Theprimary teeth were generally in

good condition, althoughroot resorption and infra-occlusion (compensated byocclusal composite onlays)occurred. In 1997, 18 of the 25patients with a total of 26retained primary molars werere-examined, comprising aclinical examination forexfoliation, extraction,loosening, and ankylosis, and

55555

“ This study’s findings suggest a higher than normal risk ofhypodontia in subjects with Down’s syndrome.”

a radiographic examinationfor root resorption, toothmorphology (crown and root),and alveolar bone contour.The examination showed thatthe degree of root resorptionwas unaltered in 20 of the 26primary molars. Three of the 6remaining primary molars hadbeen extracted and 3 showedextensive resorption. In 3 ofthe 26 primary molars theinfra-occlusion had worsened.Hence, it was concluded thatpersistence of primary secondmolars in subjects with agen-esis of one or two premolarscan be an acceptable, semi-permanent solution. It wasemphasized that furtherstudies would be needed toestablish whether this couldalso be an acceptable long-term solution. Obviously, if it isdecided to retain a primarymolar when there is premolaragenesis, the patient shouldbe followed carefully. Periodicradiographs would be needed.

Yanagida and Mori (1990)researched congenitalhypodontia using 4009 pan-oramic radiographs of pedo-dontic patients (1036 boysaged 2-5 years, 905 boysaged 6-11 years, and 22 boysaged 12 years or older; 1032girls aged 2-5 years, 985 girlsaged 6-11 years 985, and 29girls aged 12 years or older) [7].Congenital hypodontia ofprimary teeth was found in 62children (78 teeth). Congenitalhypodontia of permanentteeth was found in 314 pa-tients (566 teeth). Obviously,the majority of cases wereunilateral further complicatingthe treatment interventions by

lack of symmetry. No significantdifferences were found betweenthe right and left sides of the jawor in relation to the patient’sgender. Further, in view of the ageof the patients studies, it was notpossible to assess the agenesis ofthird permanent molars; hence,the numbers are lower than wouldotherwise be the case. Peltrola etal (1997) examined panoramicradiographs of 392 Estonianschoolchildren aged 14-17 yearsand found that, excluding thirdmolars, 14 % had missing teeth;17 % had missing third molars [8].

Comprehensive dental exami-nations and panoramic radio-graphs were used to determinethe prevalence of hypodontia in662 Australian military recruits [9].Of the sampled population, 6.3 %exhibited some degree ofhypodontia (third molar agenesisexcluded). Third molar agenesisoccurred in 22.7 % of the sample.There was no statistical differ-ence between the sexes in thirdmolar agenesis; however, womenexhibited an extremely lowincidence of absence of maxillarylateral incisors.

Hypodontia and cleftsShapira et al (1999) studiedpanoramic and periapical radio-graphs of 278 patients with cleftlip, cleft palate, or both (158males and 120 females), age 5 to18 years, to determine the fre-quency of missing secondpremolars and the possibleassociation between the cleftside and the side from which thepremolar was absent [10]. Theprevalence (18 %) of missingpremolars found in this study wasthought to be significantly higherthan that found in the general

population. A considerably higherincidence of missing secondpremolars was found in the maxillacompared with the mandible bothfor unilateral and bilateral missingteeth. The second premolar wasabsent more frequently on the leftthan on the right side, both inmales and females and in bothjaws, corresponding to the sidewhere clefts occurred more often.

Hypodontia and Down’sSyndromeKumasaka et al (1979) used pan-oramic radiographs and clinicalrecords to investigate develop-mentally absent permanent teethin 98 subjects with Down’s syn-drome (trisomy-21) [11]. This retro-spective study was made usingthe records and panoramicradiographs of subjects fromapproximately five years of agethrough to their most recentrecords. The time period coveredby records ranged from 6 to 28years. The majority of subjectswith Down’s syndrome (63 %)exhibited hypodontia, and manysubjects were missing two or moreteeth (53 %). Unlike in the generalpopulation, the most frequentlyabsent teeth were the lowerlateral incisors (23.3 %). The nextmost frequent agenesis was theupper second premolars (18.2 %),the upper lateral incisors (16.5 %),and the lower second premolars(15.3 %). This study’s findings sug-gest a higher than normal risk ofhypodontia in subjects withDown’s syndrome. Shapira et al.(2000) showed a notably highprevalence of third molar agenesis in Down’s syndrome patients(74 % of individuals older than 14years) [12].

66666

“ Teeth are essentially ectodermal appendages so dysplasia of ectoderm can affect tooth development.”

Hypodontia and Ectoder-mal DysplasiasThere are a variety of syndromesin which there can be severehypodontia – or even anadontia –in view of abnormalities in ecto-derm (Fig. 3). Teeth are essentiallyectodermal appendages sodysplasia of ectoderm can affecttooth development.

Guckes et al (1998) assessedthe pattern of permanent teethpresent in a self-selected sampleof 17 female and 35 male patientswith ectodermal dysplasia pre-senting for treatment with dentalimplants [13]. The mean age of thesample was 18.7 years (age range:5.9 to 60.9 years). Panoramicradiographs were examined

independently by two investiga-tors to determine the permanentteeth present. None of the samplereported extractions of perma-nent teeth prior to presenting forimplants. The permanent teethmost likely to be present, reportedas a percentage of the patientsample with that tooth, were:maxillary central incisors (42 %),maxillary first molars (41 %),mandibular first molars (39 %),maxillary canines (22 %) mandibu-lar second molars (17 %), maxillarysecond premolars (15 %), andmandibular premolars (12 %).Comparing dentition by quad-rants, mandibular anterior teeth(canines and incisors) were theteeth least likely to be present.

The maxillary central incisors,maxillary first molars, mandibu-lar first molars, and maxillarycanines are the most conservedteeth in hypodontia associatedwith ectodermal dysplasias.Successful use ofosseointegrated implants in theanterior mandibles of most ofthese patients suggests thathabilitation of the mandiblewith dental implant-supportedprostheses is a reasonableoption. This does not negatethe need for the patient toreceive instructions from aphysician regarding such issuesas thermal regulation andgenetic consultation. (Continued Next Issue.)

Fig. 3. Case of sex-linked hypohidroticectodermal dysplasiawith severehypodontia. The onlyteeth present are theprimary and adultcentral incisors – andthese are conical inshape. The child alsodemonstrates dry skin,and sparse hairincluding absence ofeyebrows andeyelashes.

77777

In The Recent Literature:Canine ectopia: Using panoramicradiographs, approximately halfthe subjects with palatal ectopiaof canines also have other dentalanomalies. Buccal ectopia of thecanine was not associated withsuch additional dental anomalies.Becker A, Chaushu S. Dental age inmaxillary canine ectopia. Am JOrthod Dentofacial Orthop 2000Jun; 117(6):657-62. [From the Depart-ment of Orthodontics, the HebrewUniversity-Hadassah School ofDental Medicine, Jerusalem,Israel.]

An etiologic connection betweenpalatally ectopic canines and smalland missing teeth is well establishedin the literature. Additionally, it hasbeen observed that patients withpalatally ectopic canines havedelayed dental development. Thisreport examined the validity of thislatter observation. The authorsassessed radiographically thesubjects’ dental ages using criteriaof tooth calcification, rather thantooth eruption pattern. A similardetermination was made in relationto subjects in whom buccallyectopic canines were present. Theexperimental group consisted ofpanoramic radiographs of 55consecutively treated patients withpalatally displaced maxillarycanines and of 47 consecutivelytreated patients with buccallydisplaced canines. The panoramicradiographs were compared withthose from a control group of 57consecutively treated patients withnormally placed canines. Approxi-mately half the subjects withpalatal displacement exhibited alate-developing dentition, whereasthe timing of dentition in the

remaining subjects appeared to benormal. Buccal displacement wasnot associated with a retardeddental development, and theranges of the dental age valueswere similar to those seen in thecontrol group. The results supportthe idea that there are differentetiologies for the occurrence ofbuccal versus palatal ectopia ofmaxillary canines. They also suggestthat dentitions with a palatalcanine may be of two distinctvarieties, with different dentalcharacteristics and, perhaps,different etiologies.

Dental age assessment: Panoramicradiography provides an excellentmeans of assessing the dental ageof patients; however, there is aneed to develop separate assess-ment standards for differentpopulation groups.Davidson LE, Rodd lID. Interrelation-ship between dental age andchronological age in Somalichildren. Community Dent Health2001 Mar; 18(1):27-30. [From theDepartment of Child DentalHealth, School of Clinical Dentistry,University of Sheffield, UK].

This cross-sectional study com-pared dental age with chronologi-cal age in Somali children under 16years of age and age- and gender-matched white Caucasian children,all resident in Sheffield, England. Thesample group comprised 162subjects: 84 Somali and Caucasianboys (mean age 10.6 y) and 78Somali and Caucasian girls (meanage 11.2 y). The dental age wasassessed for each subject usingexisting panoramic radiographs.

References1. American Academy of Pediatric

Dentistry. Guidelines for prescribingdental radiographs (Reviewed andreaffirmed May 1997). AAPDReference Manual 2000-2001. http://www.aapd.org/pdf/radiograph.pdf

2. Whittington BR, Durward CS. Surveyof anomalies in primary teeth andtheir correlation with thepermanent dentition. N Z Dent J1996;92(March):4-8.

3. Locht S. Panoramic radiographicexamination of 704 Danish childrenaged 9-10 years. Community DentOral Epidemiol 1980;8:375-380.

4. Neal JJ, Bowden DE. The diagnosticvalue of panoramic radiographs inchildren aged nine to ten years. Br JOrthod 1988;15:193-197.

5. Cholitgul W, Drummond BK. Jaw andtooth abnormalities detected onpanoramic radiographs in NewZealand children aged 10-15 years.NZ Dent J 2000;96(March):10-3.

6. Ith-Hansen K, Kjaer I. Persistence ofdeciduous molars in subjects withagenesis of the secondpremolars.Eur J Orthod 2000;22:239-243.

7. Yanagida I, Mori S. Statisticalstudies on numerical anomalies ofteeth in children usingorthopantomograms-congenitalhypodontia. Osaka Daigaku ShigakuZasshi 1990;35:580-593.

8. Peltola JS, Wolf J, Mannik A, RussakS, Seedre T, Sirkel M, Vink M.Radiographic findings in the teethand jaws of 14- to 17-year-oldEstonian schoolchildren in Tartu andTallinn. Acta Odontol Scand1997;55:31-35.

9. Lynham A. Panoramic radiographicsurvey of hypodontia in AustralianDefence Force recruits. Aust Dent J1990;35:19-22.

10. Shapira Y, Lubit E, Kuftinec MM.Congenitally missing secondpremolars in cleft lip and cleftpalate children. Am J OrthodDentofacial Orthop 1999;115:396-400.

11. Kumasaka S, Miyagi A, Sakai N,Shindo J, Kashima I. Oligodontia: aradiographic comparison ofsubjects with Down syndrome andnormal subjects. Spec Care Dentist1997;17:137-141.

12. Shapira J, Chaushu S, Becker A.Prevalence of tooth transposition,third molar agenesis, and maxillarycanine impaction in individuals withDown syndrome. Angle Orthod2000;70:290-296.

13. Guckes AD, Roberts MW, McCarthyGR. Pattern of permanent teethpresent in individuals with ectoder-mal dysplasia and severehypodontia suggests treatmentwith dental implants. Pediatr Dent1998;20:278-280.

©2003 Panoramic Corporation (1-03)

88888

“ Radiographic changes in the position of impacted third molarteeth can be considerable even after the usual age for eruptionof such teeth.”

Comparisons of the differencebetween dental age and chrono-logical age were made for eachgender and both ethnic groups.Independent sample t tests wereemployed for statistical analysis.The level of significance was setat p ~ 0.05. The mean differencebetween dental age and chrono-logical age was found to be 1.0years for Somali boys, 0.2 years forCaucasian boys, 1.2 years forSomali girls, and 0.5 years forCaucasian girls. The differencebetween dental and chronologi-cal age was significantly greaterin Somali subjects than in Cauca-sian children. The authors con-clude that Somali children aremore dentally advanced thantheir Caucasian peers. This findingunderlines the need for popula-tion-specific dental developmentstandards for accurate dentalage assessment.

Impacted third molars: Radio-graphic changes in the positionof impacted third molar teethcan be considerable even afterthe usual age for eruption of suchteeth.Venta I, Turtola L, YlipaavalniemiP. Radiographic follow-up ofimpacted third molars from age20 to 32 years. Int J Oral Maxillo-facial Surg 2001 Feb; 30(1):54- 7.[From the Department of OralMedicine, University of Helsinki,Finland.]

Nineteen patients (13 male, sixfemale) with 34 impacted thirdmolars (21 in the mandible and 13in the maxilla) were followed using

panoramic radiographs from age20 to 32 years. All were examinedclinically and panoramic radio-graphs were taken at baseline andat the end of the study. Radio-graphic criteria included toothresorption, follicular enlargement,root development, change ininclination of the third molar, stateof impaction, and the relativedepth of the third molar in boneand its relation both to the ramusof the mandible and to thesecond molar tooth. In the man-dible, the mean change in inclina-tion was 19° with 76 % of teethchanging in angulation. In themaxilla, only 23 % of the teethchanged in inclination. The stateof impaction (soft tissue, partiallyin bone, completely in bone) hadchanged for 44 % of the teeth.According to a questionnaire, nopain or other symptoms in theregion of the third molars werereported by 74 % of the patientsduring the 12-year study period.The authors conclude that consid-erable radiographic changes,without notable symptoms, canoccur in terms of tooth inclinationand the state of impaction ofthird molars after the usual agefor their eruption.

Second molar eruption patterns:Panoramic radiographs can beused to assess the eruptionpatterns and space availabilityfor second permanent molars.Tsai llli. Eruption process of thesecond molar. ASDC J Dent Child2000 Jul; 67(4):275- 81. [From theDepartment of Pedodontics,School of Dentistry, China Medi-

cal College, Taichung, Taiwan,Republic of China.]

This study observed the eruptionprocess of maxillary and mandibu-lar second molars by evaluating 238panoramic radiographs. The devel-opmental of the second molars wasdivided into four stages: completionof crown calcified = stage 1; initialroot formation = stage 2; initialformation of the radicular bifurca-tion = stage 3; and root lengthequal to crown height = stage 4.The mesiodistal crown width of thefirst and second molars, axialinclination and eruption rate ofthese teeth, and the space avail-able for their emergence wasmeasured at each stage. Statisticalanalysis was performed to assesschanges in development. Mandibu-lar second molars began to eruptat stage 3 and maxillary secondmolars at stage 2. The axial inclina-tion of the mandibular secondmolars was essentially unchangedfrom stages 1 to 4 but maxillarysecond molars uprighted graduallyfrom stage 1 to 4. The availablespace increased significantly fromstage 1 to 2 in both jaws. It is sug-gested that the space available foremergence of the second molar isprepared before stage 2, and thenthe tooth begins to erupt. For themaxillary second molars, there wasa further increase in the availablespace after stage 3. A negativecorrelation was determined be-tween the mesiodistal crown widthof the mandibular second molarand the available jaw space atstage 2. A positive correlation wasseen between the mesiodistalcrown width of maxillary secondmolars and the available jaw spaceat stage 3.

(847) 458-0063

(847) 458-0063

2260 Wendt St., Algonquin, IL 60102