Agenesis of permanent maxillary lateral incisors in South Australian twins

The genetic basis of hypodontia in dental development

Dental agenesis is one of the most common developmental anomalies in humans, characterised by the developmental absence of one or more teeth. It can present as an isolated condition (non-syndromic hypodontia) or associated with a syndrome (syndromic hypodontia). This paper aims to review the genetic basis of hypodontia with reference to aetiology, classification and the subsequent clinical features.Significant progress has been made to identify the developmental basis of tooth formation, though there is still a lack of knowledge within the literature of the aetiological basis of inherited tooth loss.Gene anomalies or mutations in WNT10A, MSX1, PAX9, AXIN2 and EDA appear to be most critical during tooth development, leading to various forms of tooth agenesis.

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Aim

The primary aim of this study was to evaluate the gender-based differences in patients with hypodontia. As a secondary outcome, the study looked into the correlation between hypodontia and other dental clinical features among Kosovar adolescents.

Material and Methods

3,306 students, aged between 15-21 years were examined in schools in Kosovo. Examinations were performed using a dental mirror to assess the number of teeth present, and dental impressions were taken from hypodontia subjects. Panoramic and periapical radiographs, as well as intraoral photographs, were taken in subjects who were suspected to have hypodontia to verify the diagnosis.

Results

77 of the examined subjects had hypodontia, among which 46 were females (59.7%) and 31 were males (40.3%). The most frequently missing teeth were the maxillary lateral incisors, followed by the mandibular second premolars. 68 patients (88.3%) had at least one dental clinical feature concurrent with hypodontia.

Conclusion

No significant difference was noted in the prevalence of hypodontia according to gender. Teeth rotation was the most commonly observed clinical feature followed by inclination.

De novo EDA mutations: Variable expression in two Egyptian families

OBJECTIVE

Mutations in the EDA gene, encoding the epithelial morphogen ectodysplasin-A, can result in different but overlapping phenotypes. Therefore the aim of the study was to search for etiological variations of EDA and other candidate genes in two unrelated Egyptian male children with sporadic non-syndromic tooth agenesis (NTA) and hypohidrotic ectodermal dysplasia (HED).

DESIGN

Direct sequencing of the coding regions including exon-intron boundaries of EDA, MSX1, PAX9, WNT10A and EDAR was performed in probands and their available family members.

RESULTS

Two etiological mutations were found in the EDA coding region. The patient with NTA in both deciduous and permanent dentition was a carrier of a novel in-frame deletion situated in the short collagenous domain (c.663-680delTCCTCCTGGTCCTCAAGG, p.222-227delPPGPQG). The second mutation, located outside the minimal furin consensus motif (c.463C>T, p.Arg155Cys, rs132630312), was identified in the patient exhibiting all typical features of HED. The identified EDA mutations were not detected in probands' family members as well as in 188 unrelated control individuals. No pathogenic variants were found in the MSX1, PAX9, WNT10A and EDAR genes.

CONCLUSION

Our results increase the knowledge of the spectrum of EDA mutations and confirm that this gene is an important candidate gene for two developmental diseases sharing the common feature of the congenital lack of teeth. In addition, these results can support the hypothesis that X-linked HED and EDA-related NTA are the same disease with different degrees of severity.

Prevalence of hypodontia in orthodontic patients in Brasilia, Brazil

The purpose of this retrospective study was to determine the prevalence of hypodontia and associated dental anomalies in patients undergoing orthodontic treatment in Brasília, Brazil, over a 2 year period (1998-2000). The records of 1049 orthodontic patients between 10 and 15.7 years of age (507 males and 542 females) from 16 orthodontic clinics were analysed. Descriptive statistics were performed for the study variables. A chi-square test was used to determine the difference in the prevalence of hypodontia between genders. The prevalence of hypodontia was 6.3 per cent (39.4 per cent males and 60.6 per cent females) with no statistically significant difference between the genders. One case of oligodontia was observed. The maxillary lateral incisor was the most frequently missing tooth, followed by the mandibular second premolar. All cases of hypodontia, except one, were associated with at least one other dental anomaly. These associated dental anomalies were retained primary teeth (30.3 per cent), ectopic canine eruption (25.8 per cent), taurodontism (21.2 per cent), and peg-shaped maxillary lateral incisors (16.7 per cent).

Epigenetic influences may explain dental differences in monozygotic twin pairs

BACKGROUND

Comparisons between monozygotic (MZ) co-twins have tended to focus on the similarities between their dentitions rather than differences. The aim of this study was to determine the prevalence of discordant expression for simple hypodontia and supernumerary teeth in MZ twin pairs and to explain how phenotypic differences might occur despite their similar genotypes.

METHODS

Records of 278 pairs of MZ twins, including dental casts and radiographs, were examined and the prevalences of discordant expression for missing upper lateral incisors (ULI) or second premolars (PM2), and of mesiodentes, were determined. Zygosities were confirmed by comparisons of blood markers and DNA.

RESULTS

There was evidence of at least one missing ULI or PM2 in 24 of the 278 MZ pairs (8.6 per cent), with 21 of these 24 pairs (87.5 per cent) showing discordant expression. Nine of the 278 MZ pairs (3.2 per cent) displayed evidence of mesiodentes, with eight of these nine pairs (88.9 per cent) being discordant.

CONCLUSION

Our findings show that differences in the expression of missing or extra teeth occur often between MZ co-twins whose genetic make-up predisposes them to simple hypodontia or mesiodentes. We postulate that minor variations in epigenetic events during odontogenesis may account for these distinct differences.

The value of twins in dental research

Due to recent advances in molecular genetics, studies of twins will continue to provide important insights into how genetic and environmental factors contribute to variation in human physical and behavioural traits and disorders. This review emphasizes that biometrical genetic studies of twins are particularly valuable in complementing and directing molecular approaches to facilitate the detection of quantitative trait loci. It also describes several other research models involving twins, apart from the traditional comparison of similarities in monozygotic (identical) and dizygotic (non-identical) pairs, that have the potential to provide new information in the future. Current knowledge about the genetic bases of common dental problems is summarized and future directions in dental research involving twins are outlined.

Missing lateral incisors in Iron Age South-East Asians as possible indicators of dental agenesis

The absence of lateral incisors is generally a reflection of agenesis or hypodontia, with a significant genetic basis and possibly environmental influence on the phenotypic expression. A human skeletal sample from the Iron Age cemetery of Noen U-Loke in Thailand has a very high prevalence at 79% of adults (30/38) with at least one incisor missing in either maxilla or mandible. If the cause of this high rate is genetic, it may be indicative of homogeneity, and, therefore, endogamy and probably isolation, of the population represented. Supporting agenesis as the explanation for this is the lack of space between the central incisors and canines in more than half the cases. An alternative explanation is that the teeth may have been lost during life through pathology or deliberate removal (ablation). There is no evidence in the form of remodelled lesions for pathological loss of the teeth. Although there were no significant differences between males and females in the numbers of teeth missing, there were significant differences in the patterns of loss, with males having more missing teeth on the right and females more on the left. No evidence was found in the clinical literature of agenesis involving side preference by sex, so this may indicate deliberate removal of the teeth. Males were also more likely than females to have no space for the missing teeth. Ablation of teeth has been recorded in other prehistoric South-East Asian populations but in these cases the evidence was much clearer. Agenesis seems to offer the most likely explanation for the missing teeth at Noen U-Loke and if so, indicates that a small, isolated population may develop a very high rate of hypodontia, with a side preference dependent on sex.

Genetic aspects of dental disorders

This paper reviews past and present applications of quantitative and molecular genetics to dental disorders. Examples are given relating to craniofacial development (including malocclusion), oral supporting tissues (including periodontal diseases) and dental hard tissues (including defects of enamel and dentine as well as dental caries). Future developments and applications to clinical dentistry are discussed. Early investigations confirmed genetic bases to dental caries, periodontal diseases and malocclusion, but research findings have had little impact on clinical practice. The complex multifactorial aetiologies of these conditions, together with methodological problems, have limited progress until recently. Present studies are clarifying previously unrecognized genetic and phenotypic heterogeneities and attempting to unravel the complex interactions between genes and environment by applying new statistical modelling approaches to twin and family data. Linkage studies using highly polymorphic DNA markers are providing a means of locating candidate genes, including quantitative trait loci (QTL). In future, as knowledge increases; it should be possible to implement preventive strategies for those genetically-predisposed individuals who are identified to be at risk.

Hypodontia: genotype or environment? A case report of monozygotic twins

A case report is presented of monozygotic twins with variable expression of hypodontia. DNA fingerprinting was used to confirm monozygosity, and this evidence supports the theory that genetic coding is not the sole controlling factor in tooth agenesis. It is suggested that DNA fingerprinting should be considered the gold standard for determination of monozygosity.