Hypodontia

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Hypodontia
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ICD-10 K00.0
ICD-9 520.0
MeSH D000848

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List of terms related to Hypodontia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In dentistry, hypodontia is the condition at which the patient has missing teeth as a result of their failure to develop. Hypodontia describes a situation where the patient is missing up to 6 teeth, excluding the 3rd molars. Missing third molars occur in 9-30% of population. In primary dentition the maxilla is more affected, with the condition usually involving the maxillary lateral incisor.

Classification

The condition of missing over 6 teeth, excluding 3rd molars or wisdom teeth, is called oligodontia. The condition for missing all teeth, either primary and/or permanent), is called anodontia. A similar condition is hyperdontia, in which there are more than the usual number of teeth.

Many other terms to describe a reduction in number of teeth appear in the literature: oligodontia, anodontia, aplasia of teeth, congenitally missing teeth, absence of teeth, agenesis of teeth and lack of teeth.[1]

Pathophysiology

The cause of isolated missing teeth remains unclear, but the condition is believed to be associated with genetic or environmental factors during dental development. Missing teeth have been reported in association with increased maternal age, low birth weight, multiple births and rubella virus infection during embryonic life.[citation needed]

There is a possible correlation between tooth agenesis and innervation.[2][3][4][5][6] A relationship was also postulated between abnormalities of the brainstem and the presence of agenesis.[7]

Hypodontia is often familial, and can also be associated with genetic disorders such as ectodermal dysplasia or Down syndrome. Hypodontia can also been seen in people with cleft lip and palate.

Among the possible causes are mentioned genetic, hormonal, environmental and infectious.

Etiology due to hormonal defects: idiopathic hypoparathyroidism and pseudohypoparathyroidism.[8][9] Exists the possibility that this defect depends on a moniliasis (candidiasis, candida endocrinopathy syndrome).[8][10][11]

Environmental causes involving exposure to PCBs (ex.dioxin),[12][13][14] radiation,[15][16][17] anticancer chemotherapeutic agents,[18] allergy [19] and toxic epidermal necrolysis after drug.[20]

Infectious causes of hypodontia: rubella,[21] candida.[22]

The Journal of the American Dental Association published preliminary data suggesting a statistical association between hypodontia of the permanent teeth and epithelial ovarian cancer (EOC). The study shows that women with EOC are 8.1 times more likely to have hypodontia than are women without EOC. The suggestion therefore is that hypodontia can serve as a "marker" for potential risk of EOC in women.[23]

Also the increased frequency of hypodontia in twins and low birth weight in twins with hypodontia suggests that environmental factors during perinatal are responsible hypodontia.[24][25]

Genetics

Genetic causes also involve the genes MSX1 and PAX9.[26][27] But MSX1 and MSX2 are excluded as candidate genes for hypodontia.[28]

Genetic associations for selective tooth agenesis ("STHAG") include:

Type OMIM Gene Locus
STHAG1 106600 MSX1 4p16
STHAG2 602639 ? 16q12
STHAG3 604625 PAX9 14q12
STHAG4 150400 ? ?
STHAG5 610926 ? 10q11
STHAG6 613097 LTBP3 11q12
STHAGX1 313500 ? X chromosome

==Epidemiology and Demographics In caucasians, the most common missing teeth are the wisdom teeth (25-35%), the upper lateral incisors (2%) the lower second premolars (3%), or the upper second premolar, with a 4:1 female to male ratio. The prevalence of missing primary teeth is found at 0.1-0.9%, with a 1:1 male to female ratio. Excluding the third molars, missing permanent dentition accounts for 3.5-6.5%. Similar trends of missing teeth can be seen in approximately 3-10% of orthodontic patients.[29] [30]


30-50% of people with missing primary teeth will have missing permanent teeth, as well.


References

  1. Fekonja A (2005). "Hypodontia in orthodontically treated children". European Journal of Orthodontics. 27 (5): 457–60. doi:10.1093/ejo/cji027. PMID 16043466. Unknown parameter |month= ignored (help)
  2. Chávez-Lomeli M E, Lory J M, Pompa J A, Kjær I. (1996). "The human mandibular canal arises from three separate canals innervating different tooth groups" (PDF). J Dent Res. 75 (8): 1540–4. doi:10.1177/00220345960750080401. PMID 8906121.
  3. Kjær I, Kocsis G, Nodal M, Christensen L R. (1994). "Aetiological aspects of mandibular tooth agenesis—focusing on the role of nerve, oral mucosa, and supporting tissues". Eur J Orthod. 16 (5): 371–5. doi:10.1093/ejo/16.5.371. PMID 7805810. Unknown parameter |doi_brokendate= ignored (help)
  4. Jacobsen J, Jørgensen J B, Kjær I. (1991). "Tooth and bone development in a Danish medieval mandible with unilateral absence of the mandibular canal". Am J Phys Anthropol. 85 (3): 15–23. doi:10.1002/ajpa.1330850104. PMID 1853939.
  5. Kjær I. (1995). "Human prenatal craniofacial development related to brain development under normal and pathologic conditions". Acta Odontol Scand. 53 (3): 135–43. doi:10.3109/00016359509005963. PMID 7572088.
  6. Kjær I. (1997). "Can the location of tooth agenesis and the location of initial bone loss seen in juvenile periodontitis be explained by neural developmental fields in the jaws?". Acta Odontol Scand. 55 (1): 70–72. doi:10.3109/00016359709091945. PMID 9083580.
  7. Linderstrom A, Samuelsson L, Huggare J. (2002). "Is tooth agenesis related to brainstem anomalies in myelomeningocele patients with Chiari II malformations?". Acta Odontol Scand. 60 (6): 337–340. doi:10.1080/000163502762667351. PMID 12512882.
  8. 8.0 8.1 Sutphin, A., Albright, F., McCune, D. J. (1943). "Five cases (3 in siblings) of idiopathic hypoparathyroidism associated with moniliasis". J. Clin. Endocr. 3 (12): 625–634. doi:10.1210/jcem-3-12-625.
  9. Jensen SB, Illum F, Dupont E (1981). "Nature and frequency of dental changes in idiopathic hypoparathyroidism and pseudohypoparathyroidism". Scandinavian Journal of Dental Research. 89 (1): 26–37. PMID 6262903. Unknown parameter |month= ignored (help)
  10. Muriel M. McLean (1954). "Chronic Idiopathic Hypoparathyroidism Associated with Moniliasis". Arch Dis Child. 29 (147): 419–421. doi:10.1136/adc.29.147.419. PMC 2011654. PMID 13208313.
  11. Ritchie GM. (1965). "Dental manifestations of pseudohypoparathyroidism". Arch Dis Child. 40 (213): 565–572. doi:10.1136/adc.40.213.565. PMC 2019454. PMID 5830003.
  12. Alaluusua S, Lukinmaa PL, Torppa J, Tuomisto J, Vartiainen T (1999). "Developing teeth as biomarker of dioxin exposure". Lancet. 353 (9148): 206. doi:10.1016/S0140-6736(05)77214-7. PMID 9923879. Unknown parameter |month= ignored (help)
  13. Alaluusua S; Calderara P; Gerthoux PM; et al. (2004). "Developmental dental aberrations after the dioxin accident in Seveso". Environmental Health Perspectives. 112 (13): 1313–8. doi:10.1289/ehp.6920. PMC 1247522. PMID 15345345. Unknown parameter |month= ignored (help); Unknown parameter |author-separator= ignored (help)
  14. Guo YL, Lambert GH, Hsu CC, Hsu MM (2004). "Yucheng: health effects of prenatal exposure to polychlorinated biphenyls and dibenzofurans". International Archives of Occupational and Environmental Health. 77 (3): 153–8. doi:10.1007/s00420-003-0487-9. PMID 14963712. Unknown parameter |month= ignored (help)
  15. Niswander JD, Sujaku C (1963). "Congenital anomalies of teeth in Japanese children". American Journal of Physical Anthropology. 21 (4): 569–74. doi:10.1002/ajpa.1330210413. PMID 14185534. Unknown parameter |month= ignored (help)
  16. Sevbitov AV (2004). "[Remote effects of the Chernobyl accident: evaluation of the maxillodental status of the children]". Stomatologiia (in Russian). 83 (1): 44–7. PMID 15021876.
  17. Kaste SC; Goodman P; Leisenring W; et al. (2009). "Impact of radiation and chemotherapy on risk of dental abnormalities: a report from the Childhood Cancer Survivor Study". Cancer. 115 (24): 5817–27. doi:10.1002/cncr.24670. PMID 19834960. Unknown parameter |month= ignored (help); Unknown parameter |author-separator= ignored (help)
  18. Näsman M, Forsberg CM, Dahllöf G (1997). "Long-term dental development in children after treatment for malignant disease". European Journal of Orthodontics. 19 (2): 151–9. doi:10.1093/ejo/19.2.151. PMID 9183064. Unknown parameter |month= ignored (help)
  19. Yamaguchi T, Tomoyasu Y, Nakadate T, Oguchi K, Maki K (2008). "Allergy as a possible predisposing factor for hypodontia". European Journal of Orthodontics. 30 (6): 641–4. doi:10.1093/ejo/cjn043. PMID 18687988. Unknown parameter |month= ignored (help)
  20. Fréderick Gaultier; Juliette Rochefort; Marguerite-Marie Landru; Laurence Allanore; Adrien Naveau; Jean-Claude Roujeau; Bruno Gogly (2009). "Severe and Unrecognized Dental Abnormalities After Drug-Induced Epidermal Necrolysis". Arch Dermatol. 475 (11): 1332–1333. doi:10.1001/archdermatol.2009.233. PMID 19917972. Unknown parameter |month= ignored (help)
  21. Charlene Chun-Lam Wu, Ricky Wing-Kit Wong, Urban Hägg (2007). "A review of hypodontia: the possible etiologies and orthodontic, surgical and restorative treatment options—conventional and futuristic" (PDF). Hong Kong Dental Journal. 4: 113–21.
  22. Kinirons MJ. (1983). "Candidal invasion of dentine complicating hypodontia". British Dental Journal. 154 (12): 400–1. doi:10.1038/sj.bdj.4805102. PMID 6576802. Unknown parameter |month= ignored (help)
  23. Chalothorn LA; Beeman CS; Ebersole JL; et al. (2008). "Hypodontia as a risk marker for epithelial ovarian cancer: a case-controlled study". Journal of the American Dental Association. 139 (2): 163–9. PMID 18245684. Unknown parameter |month= ignored (help); Unknown parameter |author-separator= ignored (help)
  24. "THE RELATIONSHIP BETWEEN BIRTH WEIGHT AND HYPODONTIA IN TWINS, 12 MAY 1969". NAVAL DENTAL RESEARCH INST GREAT LAKES ILL by Keene,Harris J. Retrieved 2010-05-22.
  25. Kindelan JD, Rysiecki G, Childs WP. (1998). "Hypodontia: genotype or environment? A case report of monozygotic twins". Br J Orthod. 25 (3): 175–178. doi:10.1093/ortho/25.3.175. PMID 9800013.
  26. Nieminen P (2009). "Genetic basis of tooth agenesis". Journal of Experimental Zoology. Part B, Molecular and Developmental Evolution. 312B (4): 320–42. doi:10.1002/jez.b.21277. PMID 19219933. Unknown parameter |month= ignored (help)
  27. De Coster PJ, Marks LA, Martens LC, Huysseune A (2009). "Dental agenesis: genetic and clinical perspectives". Journal of Oral Pathology & Medicine. 38 (1): 1–17. doi:10.1111/j.1600-0714.2008.00699.x. PMID 18771513. Unknown parameter |month= ignored (help)
  28. Nieminen P, Arte S, Pirinen S, Peltonen L, Thesleff I (1995). "Gene defect in hypodontia: exclusion of MSX1 and MSX2 as candidate genes". Hum Genet. 96 (3): 305–308. doi:10.1007/BF00210412. PMID 7649547.
  29. Medina AC (2012). "Radiographic study of prevalence and distribution of hypodontia in a pediatric orthodontic population in Venezuela". Pediatr Dent. 34 (2): 113–116. PMID 22583882.
  30. Vahid-Dastjerdi E, Borzabadi-Farahani A, Mahdian M, Amini N (2010). "Non-syndromic hypodontia in an Iranian orthodontic population". J Oral Sci. 52 (3): 455–461. doi:10.2334/josnusd.52.455. PMID 20881340.

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