Exclusion of PAX9 and MSX1 mutation in six families affected by tooth agenesis. A genetic study and literature review

Identification of novel candidate genes associated with non-syndromic tooth agenesis in Mongolian families

OBJECTIVES

This study aimed to identify genetic variants associated with non-syndromic tooth agenesis (TA) in nine families from Mongolia using whole-exome sequencing (WES) and bioinformatics analysis.

MATERIAL AND METHODS

The study enrolled 41 participants, including three inherited and six non-inherited families. WES analysis was performed on 14 saliva samples from individuals with non-syndromic TA. The potential candidate genes were identified through variant filtering and segregation analysis. The filtered variants were then analyzed in silico mutation impact analysis.

RESULTS

WES analysis identified 21 variants associated with TA, and 5 of these variants met all filtering criteria. These variants were located in the exome region of MAST4, ITGA6, PITX2, CACNA1S, and CDON genes. The variant in PITX2 was found in eight participants from inherited and non-inherited families, while the MAST4 variant was identified in 6 participants from inherited families.

CONCLUSIONS

The study identified various genetic variant candidates associated with TA in different family groups, with PITX2 being the most commonly identified. Our findings suggest that MAST4 may also be a novel candidate gene for TA due to its association with the Wnt signaling pathway. Additionally, we found that five candidate genes related to focal adhesion and calcium channel complex were significant and essential in tooth development.

CLINICAL RELEVANCE

Identifying new pathogenic genes associated with TA can improve our understanding of the molecular mechanisms underlying the disease, leading to better diagnosis, prevention, and treatment. Early detection of TA based on biomarkers can improve dental management and facilitate orthodontic and prosthetic treatment.

A Rare Incidence of Nonsyndromic Mandibular Incisor Agenesis in a Three-generation Family: Case Report and Literature Review

Hypodontia is an inherited condition involving the absence of one to six teeth. The permanent dentition is the most frequently affected; however, it may also affect the primary dentition. A congenitally missing tooth (CMT) is the most common dental abnormality, with the missing mandibular second premolar, maxillary lateral incisor, maxillary second premolar, and mandibular central incisor accounting for 90% of CMT in hypodontia studies. The etiology of CMT has been attributed to environmental and genetic contributing factors, with the latter having a strong influence. It may occur in isolation or in association with syndromes. Congenitally missing mandibular incisor is more common in the Asian population and females. Depending on the number and location of missing teeth, hypodontia may be a considerable issue for the clinician since it may impact occlusal balance, mastication, speech, and esthetics and often requires a multidisciplinary approach. Missing mandibular incisors are of particular interest to orthodontists because of the possibility of mandibular retrognathism, the potential for the development of malocclusion, and difficulty in achieving a balanced occlusion. This case report describes the skeletal and dental features of a nonsyndromic familial occurrence of missing mandibular incisors in three generations. A comprehensive literature search was also performed to review the familial cases with missing mandibular incisors.

How to cite this article

Selvaraj M, Sennimalai K, Samrit VD, et al. A Rare Incidence of Nonsyndromic Mandibular Incisor Agenesis in a Three-generation Family: Case Report and Literature Review. Int J Clin Pediatr Dent 2023;16(2):388-395.

Functional Analysis of Ectodysplasin-A Mutations in X-Linked Nonsyndromic Hypodontia and Possible Involvement of X-Chromosome Inactivation

BACKGROUND

Mutations of the Ectodysplasin-A (EDA) gene are generally associated with syndrome hypohidrotic ectodermal dysplasia or nonsyndromic tooth agenesis. The influence of EDA mutations on dentinogenesis and odontoblast differentiation has not been reported. The aim of this study was to identify genetic clues for the causes of familial nonsyndromic oligodontia and explore the underlying mechanisms involved, while focusing on the role of human dental pulp stem cells (hDPSCs).

MATERIALS AND METHODS

Candidate gene sequences were obtained by PCR amplification and Sanger sequencing. Functional analysis was conducted, and the pathogenesis associated with EDA mutations in hDPSCs was investigated to explore the impact of the identified mutation on the phenotype. Capillary electrophoresis (CE) was used to detect X-chromosome inactivation (XCI) in the blood of female carriers.

RESULTS

In this study, we identified an EDA mutation in a Chinese family: the missense mutation c.1013C>T (Thr338Met). Transfection of hDPSCs with a mutant EDA lentivirus decreased the expression of EDA and dentin sialophosphoprotein (DSPP) compared with transfection of control EDA lentivirus. Mechanistically, mutant EDA inhibited the activation of the NF-κB pathway. The CE results showed that symptomatic female carriers had a skewed XCI with a preferential inactivation of the X chromosome that carried the normal allele.

CONCLUSIONS

In summary, we demonstrated that EDA mutations result in nonsyndromic tooth agenesis in heterozygous females and that, mechanistically, EDA regulates odontogenesis through the NF-κB signalling pathway in hDPSCs. Due to the large heterogeneity of tooth agenesis, this study provided a genetic basis for individuals who exhibit similar clinical phenotypes.

Successful treatment modalities for missing lateral incisors- A systematic review

BACKGROUND

Effective management of Missing lateral incisor has remained a challenge for the clinicians. A multi-disciplinary approach involving orthodontist, restorative dental specialist, pediatric dental specialist, periodontist, oral surgeon and general dentist has proved ideal. Our aim is to review the ultimate esthetic success, and long term survival results between the orthodontic and restorative management of missing lateral incisor.

MATERIALS AND METHODS

Following the PRISMA guidelines, a systematic review of the published articles pertaining to the topic of interest was done. Searches were carried out in four different databases since February 2021 to April 2021.

RESULTS

A total of 580 references were found from searches conducted in PubMed, Scopus, Cochrane and Web of Science, and 19 articles were selected and analyzed fully, after screening the title and abstract, 6 articles were included for the study.

CONCLUSION

An essential orthodontic space closure in combination with modern aesthetic prosthetic tooth replacement techniques has been reported to achieve greater success.

Elements of morphology: Standard terminology for the teeth and classifying genetic dental disorders

Dental anomalies occur frequently in a number of genetic disorders and act as major signs in diagnosing these disorders. We present definitions of the most common dental signs and propose a classification usable as a diagnostic tool by dentists, clinical geneticists, and other health care providers. The definitions are part of the series Elements of Morphology and have been established after careful discussions within an international group of experienced dentists and geneticists. The classification system was elaborated in the French collaborative network "TÊTECOU" and the affiliated O-Rares reference/competence centers. The classification includes isolated and syndromic disorders with oral and dental anomalies, to which causative genes and main extraoral signs and symptoms are added. A systematic literature analysis yielded 408 entities of which a causal gene has been identified in 79%. We classified dental disorders in eight groups: dental agenesis, supernumerary teeth, dental size and/or shape, enamel, dentin, dental eruption, periodontal and gingival, and tumor-like anomalies. We aim the classification to act as a shared reference for clinical and epidemiological studies. We welcome critical evaluations of the definitions and classification and will regularly update the classification for newly recognized conditions.

Association between agenesis and root morphology of anterior teeth

Abstract Introduction Tooth agenesis is likely to affect the root teeth and should be considerated in orthodontic tratament. Objective The aim of this study was to assess the association between agenesis and root morphology of anterior teeth. Material and method The anterior teeth of 51 individuals were evaluated on 102 periapical radiographs and then divided into three groups: Group 1 (n=16) – no tooth agenesis; Group 2 (n=17) – only third molar agenesis; and Group 3 (n=18) – tooth agenesis of premolars or lateral incisors. Root morphology of anterior teeth was evaluated and the roots were classified as short, blunt, apically bent, and pipette-shaped. Fisher’s exact test was used to compare root shapes, the chi-square test was used to obtain the distribution of sexes between the groups, and ANOVA was performed to compare the ages between the groups. The significance level was set at 5% for all analyses. Result There was significant difference in root shapes (P<0.05) between the groups. Blunt roots were the most prevalent in all groups, but their rate was higher in Group 3 (83%). Conclusion There was association between agenesis and root morphology of anterior teeth.

Mutation analysis by direct and whole exome sequencing in familial and sporadic tooth agenesis

Dental agenesis is one of the most common congenital craniofacial abnormalities. Dental agenesis can be classified, relative to the number of missing teeth (excluding third molars), as hypodontia (1 to 5 missing teeth), oligodontia (6 or more missing teeth), or anodontia (lack of all teeth). Tooth agenesis may occur either in association with genetic syndromes, based on the presence of other inherited abnormalities, or as a non-syndromic trait, with both familiar and sporadic cases reported. In this study, we enrolled 16 individuals affected by tooth agenesis, prevalently hypodontia, and we carried out direct Sanger sequencing of paired box 9 (PAX9) and Msh homeobox 1 (MSX1) genes in 9 subjects. Since no mutations were identified, we performed whole exome sequencing (WES) in the members of 5 families to identify causative gene mutations either novel or previously described. Three individuals carried a known homozygous disease mutation in the Wnt family member 10A (WNT10A) gene (rs121908120). Interestingly, two of these individuals were siblings and also carried a heterozygous functional variant in EDAR-associated death domain (EDARADD) (rs114632254), another disease causing gene, generating a combination of genetic variants never described until now. The analysis of exome sequencing data in the members of other 3 families highlighted new candidate genes potentially involved in tooth agenesis and considered suitable for future studies. Overall, our study confirmed the major role played by WNT10A in tooth agenesis and the genetic heterogeneity of this disease. Moreover, as more genes are shown to be involved in tooth agenesis, WES analysis may be an effective approach to search for genetic variants in familiar or sporadic tooth agenesis, at least in more severe clinical manifestations.

Epithelial - Mesenchymal Interactions in Tooth Development and the Significant Role of Growth Factors and Genes with Emphasis on Mesenchyme - A Review

The recent advancements in medical research field mainly highlights the genetic and molecular aspects of various disease processes and related treatment options, in a specialized "custom-made" approach. The medical and dental field has made tremendous progress in providing even with the smallest insight into pathological entities, thus, making patient management more fruitful. But, short comings have occurred in dental treatments involving odontogenic lesions mainly due to poor understanding of the developmental cycle involved during early stages of developmental process. Multiple numbers of interactions take place during embryo formation and further proliferation of tissue. One such important step is the interaction between epithelium and mesenchyme which tantamount to functional requirements of an individual tooth. The role of extra cellular molecules and genes has to be studied in depth to assess the impact and significance attached to it as the synergistic function of various elements underlines the complex process of development.