Reduction In Tooth Size Research Articles

Tooth Abnormalities and Their Age-Dependent Occurrence in Leukemia Survivors.

The multidrug nature of anticancer treatment and different treatment protocols used in the studies are likely to be a major limitation in establishing real risk factors determining the occurrence of dental abnormalities. The authors aimed to establish a relationship between the duration and the dose of chemotherapy and the number of tooth adverse effects in the group receiving the same treatment. Of the 40 anticancer therapy recipients who attended the outpatient dental clinic, 7 leukemia survivors receiving the treatment according to the ALL IC-BFM 2002 protocol were selected. The study group consisted of four females and three males aged 92 to 207 months at the time of dental examination and 29 to 91 months at leukemia diagnosis. As a result of the clinical and radiological examination, dental abnormalities such as agenesis, tooth size reduction, root abnormalities, and taurodontia were identified, and the medical records of all survivors were reviewed in terms of drugs administered, their doses, and treatment schedules. No correlation was observed between the treatment duration of an intensive therapy, the entire therapy, and the number of tooth abnormalities. No relationship was also found between the number of dental abnormalities and the cumulative dose of vincristine, L-asparaginase, methotrexate, cyclophosphamide, cytarabine, and 6-mercaptopurine. The age at the onset of antineoplastic therapy is likely to be the strongest risk factor for toxic injury during tooth development.

Crown dimensions of Malay deciduous teeth: Sex dimorphism and tooth size in Asia

ObjectiveThis study documents deciduous tooth crown dimensions and sex dimorphism in modern Malay children of Indonesia. Comparisons are made with living and prehistoric East and South Asians to better understand tooth size variation in space and through time. DesignMeasurements of the dental crown were made with a Mitutoyo digimatic caliper, interfaced with a Dell laptop, running Microsoft Excel (2003). Buccolingual (BL) measurements of maximum crown breadth of modern Malay were made by the first author. All prehistoric South Asian comparative samples were measured by the first author, data for living East and South Asians were taken from published data. All statistical analyses were conducted using SAS, Inc. (9.1 for Windows). ResultsCrown dimensions, sex dimorphism and crown areas are presented and reveal consistencies in tooth size and level of sexual dimorphism with East and South Asian living samples. Sex dimorphism in Malay crown dimensions is low (1.1%) among Asians. Total crown area is 484.7 mm2, similar to living Japanese (486.3 mm2), but greater than Hindus (476.4 mm2) of India. Compared with prehistoric groups the Malay have reduced tooth size, especially when compared with Neolithic (MR 3, 535.3 mm2) and Chalcolithic (MR 2, 515.3 mm2) Mehrgarh, Pakistan. ConclusionSex dimorphism in Malay deciduous crown dimensions is lower than average among Asians and total tooth crown area is similar to living East and South Asians but is reduced when compared with prehistoric Asian samples.

Growth of teeth and bones in adult subjects with congenital untreated isolated growth hormone deficiency

ObjectiveTo understand the growth of teeth and mandibular and maxillary bones in subjects with isolated growth hormone deficiency (IGHD). Material and methodsMesiodistal tooth width of 28 maxillary and mandibular dental models of 14 adult IGHD subjects (9 men) were digitalized and compared to 40 models of 20 normal-statured controls (11 men). The mean SDS of the maxillary and mandibular teeth were compared with height, cephalic perimeter, total anterior facial height, total maxillary and mandibular length, and maxillary and mandibular arches. ResultsAll average mesiodistal dimensions in absolute values of the 14 dental pairs were reduced in the IGHD group. Eight of 28 (28.6%) mesiodistal dimensions in IGHD subjects of both sexes had an average SDS below −2, thirteen of them (46.4%) had mean SDS between −1 and − 2, and seven of them (25.0%) had SDS above −1. The highest SDS values were the upper lateral incisor (−0.32 in women), and the upper canine (−0.91 in men). The lowest SDS values were the 2nd upper molar (−3.51 in men), and the 2nd upper premolar (−2.64 in women). The ascending order of the mean SDS was height, total maxillary length, total mandibular length, total anterior height of the face, cephalic perimeter, the maxillary arches width, the mesiodistal width of the mandibular teeth, the mesiodistal width of the maxillary teeth and the mandibular arches width. ConclusionsReduction in mesiodistal width is present in untreated IGHD adults with magnitude of tooth size reduction being lower than height, cephalic perimeter, total anterior facial height, and most jaw measurements. IGHD abolishes the sexual dimorphism in mesiodistal dental measures.

Duration and dose of chemotherapy and dental development.

Given the susceptibility of developing tissues to drugs, even small doses of anticancer drugs may affect odontogenesis. Although any toxic effect is transient, the treatment regimens are based on repeated drug administration. The study aimed to establish the impact of antineoplastic therapy on the occurrence of longterm adverse dental effects in a dose-dependent manner in young survivors treated for cancer before 10 years of age. In total, 37 cancer survivors treated with antineoplastic therapy before 10 years of age underwent a dental examination with a thorough analysis of panoramic radiographs. A total of 236 teeth with 243 different developmental abnormalities were revealed in 28 survivors. Agenesis, tooth size reduction, taurodontia, and enamel and root abnormalities were diagnosed. All survivors received multi-agent chemotherapy, with the most frequently used drugs being vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), ifosfamide (IF), etoposide (VP-16), carboplatin (CBDCA), cisplatin (CDDP), and actinomycin-D (ActD). A detailed analysis of medical records was also performed to assess the relationship between the treatment duration as well as the cumulative drug dose administered and the occurrence of particular disturbances. When analyzing the treatment duration and the drug doses in the affected and non-affected participants, there were no statistically significant differences between the survivors with different disturbances within most of the specific drug groups. In some groups, the mean cumulative treatment dose was significantly higher in the non-affected patients. According to Spearman's rho, no significant relationships were observed. In the present study, no significant differences in terms of treatment duration or drug doses were observed between the patients with particular abnormalities. The developmental stage of tooth formation during chemotherapy is likely the most important factor influencing dental changes. For future research with respect to different treatment protocols, an analysis of a more homogenous group of survivors is warranted.

Duration and dose of chemotherapy and dental development

The study aimed to establish an anticancer drug- and its dose-dependency of long-term adverse dental effects occurrence in cancer survivors. The objective of the research was a dental examination with a thorough analysis of panoramic radiographs in 37 cancer survivors treated with antineoplastic therapy before 10 year of age and at least 2 years after therapy completion. A total of 236 teeth with 243 different developmental abnormalities were revealed. Twenty-eight survivors presented with 236 teeth with 243 developmental abnormalities, such as agenesis, tooth size reduction, taurodontia and enamel and root abnormalities. All the survivors received multiagent chemotherapy with the most frequent use of VCR, DXR, CP, IF, VP-16, CBDCA, CDDP, ACTD. A detailed analysis of medical records in order to assess a relationship between treatment duration and cumulative drug doses administered and occurrence of particular disturbances was also performed. There were no statistically significant differences between survivors with different disturbances within almost all particular drug groups when analyzing treatment duration and drug doses in the affected and non-affected participants. In some groups the mean cumulative treatment dose was statistically significantly higher in the non-affected patients. According to Spearman's rho, no reasonable relationship can be confirmed. With respect to different treatment protocols used an analysis of a more homogenous group of survivors seems necessary. The developmental stage of tooth formation during chemotherapy is likely to be the most important decisive factor for dental changes.

Deficiency of the SMOC2 matricellular protein impairs bone healing and produces age-dependent bone loss

Secreted extracellular matrix components which regulate craniofacial development could be reactivated and play roles in adult wound healing. We report a patient with a loss-of-function of the secreted matricellular protein SMOC2 (SPARC related modular calcium binding 2) presenting severe oligodontia, microdontia, tooth root deficiencies, alveolar bone hypoplasia, and a range of skeletal malformations. Turning to a mouse model, Smoc2-GFP reporter expression indicates SMOC2 dynamically marks a range of dental and bone progenitors. While germline Smoc2 homozygous mutants are viable, tooth number anomalies, reduced tooth size, altered enamel prism patterning, and spontaneous age-induced periodontal bone and root loss are observed in this mouse model. Whole-genome RNA-sequencing analysis of embryonic day (E) 14.5 cap stage molars revealed reductions in early expressed enamel matrix components (Odontogenic ameloblast-associated protein) and dentin dysplasia targets (Dentin matrix acidic phosphoprotein 1). We tested if like other matricellular proteins SMOC2 was required for regenerative repair. We found that the Smoc2-GFP reporter was reactivated in adjacent periodontal tissues 4 days after tooth avulsion injury. Following maxillary tooth injury, Smoc2−/− mutants had increased osteoclast activity and bone resorption surrounding the extracted molar. Interestingly, a 10-day treatment with the cyclooxygenase 2 (COX2) inhibitor ibuprofen (30 mg/kg body weight) blocked tooth injury-induced bone loss in Smoc2−/− mutants, reducing matrix metalloprotease (Mmp)9. Collectively, our results indicate that endogenous SMOC2 blocks injury-induced jaw bone osteonecrosis and offsets age-induced periodontal decay.

An evaluation of classical morphologic and morphometric parameters reported to distinguish wolves and dogs

Morphological and morphometric bone variation between archaeological wolves and the oldest domestic dogs commonly are used to define species differences. However, reference data often have been based on small numbers, without robust statistical support. We consulted the literature on these matters in all possible languages and tested many of the proposed species differences by examining wolf and dog skeletons from several collections, accompanied by an extensive synthesis of existing literature. We thus created large reference groups, assessing data distributions and variability. We examined mandible height, width, length, and convexity; contact points of the skull on a horizontal plane; caudal shifting of the border of the hard palate; skull size; carnassials tooth size reduction; micro-anatomical differences in teeth, snout, and skull height; and snout length and width.Our results show that skull length and related size; skull height; snout width; orbital angle; P4 and M1 mesio-distal diameter can help (albeit to a limited extent) to distinguish the oldest archaeological dogs from wolves. Based on our observations, we re-evaluated recent large Pleistocene canids reported as Paleolithic dogs and concluded instead that they fit well within the morphomentric distributions seen with Pleistocene wolves.The research presented here reflects the recent trend to critically re-evaluate axiomatic assumptions about wolf-dog differences, and to rephrase the morphological and morphometric definition of an early archaeological dog in a more suitable manner.These results are important to the international archaeological community because they place historical reports in a newer context, and create a robust (although narrow) framework for further evaluation of archaeological dogs and wolves.

Dental Reduction and Diet in the Prehistoric Ohio River Valley

Post-Pleistocene dental reduction has been documented around the globe. Dietary change is a common factor in many of the selectionist models explaining this reduction. The current study examines tooth size in the prehistoric Ohio River Valley of Indiana and Kentucky to determine if a dental reduction occurred from the Late Archaic to the Mississippian periods and, if so, to see if dietary shifts are associated with dental reduction. Data from 282 individuals are compiled from 21 sites that span from 5000 BC to AD 1400. These sites represent Late Archaic foragers, Early/Middle Woodland early horticulturalists, Late Woodland mixed-economy horticulturalists, and Mississippian agriculturalists. Previous studies have indicated that the diet became less abrasive through time in this region but became harder from the Late Archaic to the Early/Middle Woodland just to became softer again thereafter. Buccolingual diameters were taken for all suitable permanent teeth. Standard descriptive statistics, ANOVA, percent differences, and rate of change were calculated for each dental measurement to determine the degree of change between the various temporal groups. It was found that a dental reduction occurred in the Ohio River Valley that was more pronounced in females and in the maxillary molars. The general reduction in tooth size mirrors the reduction in dietary abrasiveness. By contrast, it does not seem to follow the course of dietary hardness.

Space conditions, palatal vault height, and tooth size in patients with and without palatally displaced canines: A prospective cohort study.

To assess palatal vault height, tooth size, and dental arch dimensions in patients with unilateral and bilateral palatally displaced canines compared with a control group. A sample of 66 patients (mean age: 11.5 ± 1.0 years) with 22 unilateral palatally displaced canines (UPDCs), 22 bilateral palatally displaced canines (BPDCs), and 22 controls (C) were consecutively recruited. All three groups had dental casts that were scanned digitally using the OrthoX three-dimensional model scanner. Tooth size, palatal vault height, dental arch width, dental arch depth, dental arch length, and dental arch space were measured by the same examiner using the GOM software. Remeasurements were made in 10 randomly identified patients. The palatal vault height was significantly lower in the BPDC group compared with controls. A significantly smaller mesial-distal crown width and, in general, more spacing in the maxilla were found in the UPDC and BPDC groups. No differences in arch length or arch width at the molar region were seen between the groups, while the arch length at the canine region was smaller in the UPDC and BPDC groups. However, this was observed in BPDC patients with both deciduous canines present and in most UPDC patients where the deciduous canine was present, compared with the control group, who had more permanent canines present. Patients with PDC had greater reduction in tooth size compared with the control group. The arch length and arch width were similar in patients with and without PDC.

Things and the Slow Neolithic: the Middle Eastern Transformation

This paper argues that the search for an overarching explanation for the adoption of farming and settled life in the Middle East can be enhanced by a consideration of the dependencies between humans and human-made things from the Late Glacial Maximum onwards. Often not considered in discussions of the origins of agriculture is the long process of human tooth size reduction that started in the Upper Palaeolithic and can reasonably be related to the increased use of grinding stones that created softer and more nutrient-rich plant foods. A consideration of the use of groundstone tools through the Epipalaeolithic and into the Neolithic shows that they were entangled with hearths, ovens, houses and settlements, exchange relations and notions of ownership. The practicalities of processing plants drew humans into pathways that led to intensification, population increase, sedentism and domestication. Much the same can be said for other human-made things such as sickles, storage bins, domestic animal dung and refuse. The dialectical tensions between human-thing dependence and dependency generated the movement towards Neolithicization. Human-thing dependence (involving human dependence on things, thing dependence on humans and thing dependence on other things) afforded opportunities towards which humans (always already in a given state of entanglement) were drawn in order to solve problems. But this dependence also involved dependency, limitation and constraint, leading for example to increases in labour. In order to provide that labour or in other ways to deal with the demands of things and their entanglements with other humans and things, humans made further use of the affordances of things. There was thus a generative spiral leading to sedentism and domestication.

The impact of premature birth on the permanent tooth size of incisors and first molars

Scientific evidence is insufficient to answer the question of whether premature birth causes altered tooth-crown dimensions. To evaluate permanent tooth-crown dimensions in prematurely born children and to compare the findings with full-term born controls. Preterm children of 8-10 years of age were selected from the Swedish Medical Birth Register. One group consisted of 36 extremely preterm children (born before the 29th gestational week); the other group included 37 very preterm children (born during gestational weeks 29-32). The preterm children were compared with 41 matched full-term born children. Clinical examination and study casts were performed on all children. Permanent maxillary and mandibular first molars, central incisors, and laterals were measured with a digital sliding caliper on study casts. The tooth-crowns were measured both mesio-distal and bucco-lingual. Both the mesio-distal and bucco-lingual measurements in the maxillary and mandibular first molars had a significantly smaller width in the extremely preterm group compared with the full-term group. The central incisors and lower laterals were significantly smaller mesio-distally in the extremely preterm group compared to the full-term group. A reduction in tooth size of 4-9% was found between the extremely preterm group and the full-term group for both boys and girls. The maxillary first molars and mandibular left first molar were also smaller mesio-distally in the extremely preterm group compared to the very preterm group. The results indicate that the more preterm the birth, the smaller the tooth-crown dimensions. Independent of gestational age girls had generally smaller teeth than boys. Premature birth is associated with reduced tooth-crown dimensions of permanent incisors and first molars.

Brain enlargement and dental reduction were not linked in hominin evolution

The large brain and small postcanine teeth of modern humans are among our most distinctive features, and trends in their evolution are well studied within the hominin clade. Classic accounts hypothesize that larger brains and smaller teeth coevolved because behavioral changes associated with increased brain size allowed a subsequent dental reduction. However, recent studies have found mismatches between trends in brain enlargement and posterior tooth size reduction in some hominin species. We use a multiple-variance Brownian motion approach in association with evolutionary simulations to measure the tempo and mode of the evolution of endocranial and dental size and shape within the hominin clade. We show that hominin postcanine teeth have evolved at a relatively consistent neutral rate, whereas brain size evolved at comparatively more heterogeneous rates that cannot be explained by a neutral model, with rapid pulses in the branches leading to later Homo species. Brain reorganization shows evidence of elevated rates only much later in hominin evolution, suggesting that fast-evolving traits such as the acquisition of a globular shape may be the result of direct or indirect selection for functional or structural traits typical of modern humans.

Thalassemia Major and related Dentomaxillofacial Complications: Clinical and Radiographic Overview with Reference to Dental Care

ABSTRACT Introduction Thalassemia is one of the most common genetic disorders worldwide and presents public health and social challenges in areas of high incidence. Thalassemia major (TM) type is associated with most severe clinical changes. Aim To evaluate dental and oromaxillofacial features of TM. Materials and methods The sample consisted of 54 children and adolescents with TM, 31 males and 23 females, aged 5.5 to 18.3 years (mean age 11.6 ± 3.2 years) and thalassemia-free controls. They were examined for dental caries, oral hygiene, periodontal status, orofacial features, tooth size and dental arch dimensions, dental development, and physical pattern. Clinical, radiographical, and odontometric assessments were carried out. Results Thalassemia major patients were at high risk of dental caries. The average decayed, missing, filled tooth (DMFT) value was 6.26 for 15-year-olds compared with 4.84 in the control group (p < 0.001). Poor oral hygiene and gingivitis were observed in 61.1 and 92.2% of the thalassemic patients respectively. Clinical orofacial features of TM include frontal bossing, saddle nose, and maxillary protrusion, giving a “chipmunk”-like face. Lip incompetence, dental discoloration, and pallor oral mucosa have been noted. Radiographical examination showed the following: thickened frontal bone, thinned mandibular cortex, and maxillary sinus hypoplasia. Class II malocclusion, significant reduction in tooth size and dental arch dimensions, and delay in dental development were evident. Growth retardation was present in 75.9% of the patients. Conclusion Thalassemia major produces a variety of orofacial and systemic complications that increase with age. Early diagnosis and management allow more favorable prognosis and minimize complication. Clinical significance Dental practitioners, especially working in multiracial communities, require understanding of the complications and management of the disease. How to cite this article Hattab FN. Thalassemia Major and related Dentomaxillofacial Complications: Clinical and Radiographic Overview with Reference to Dental Care. Int J Experiment Dent Sci 2017;6(2):95-104.

Tooth Size in Patients with Mild, Moderate and Severe Hypodontia and a Control Group.

Objectives:To compare tooth size between subjects with mild, moderate and severe hypodontia and a control group.Material and Methods:The study comprised 120 patients with hypodontia divided into three groups of 40 mild (≤2 teeth congenitally missing), 40 moderate (3-5 teeth congenitally missing) and 40 severe (≥6 teeth congenitally missing) hypodontia; and 40 age and sex matched controls. Tooth size was recorded by measuring the mesiodistal and buccolingual dimensions of all fully erupted teeth on study models using digital callipers and compared between all hypodontia and control groups using Two-way ANOVA and Post Hoc Tests of subgroup comparison.Results:Two-way ANOVA revealed patients with hypodontia had significantly smaller mesiodistal and buccolingual tooth dimensions compared with controls (p<0.05). Furthermore patients with more severe hypodontia demonstrated significantly smaller tooth dimensions than those in the mild and moderate hypodontia subgroups (p<0.05). The most affected tooth in terms of tooth size reduction was the maxillary lateral incisor and the least affected tooth was the mandibular first molar.Conclusion:Patients with hypodontia have smaller tooth dimensions than control. Tooth size appears to be affected by the degree of hypodontia, with severe hypodontia having a greater effect on tooth size reduction. The findings of this study may contribute to understanding the aetiology of hypodontia and aid the multidisciplinary management of this complex condition.

A splicing mutation in VPS4B causes dentin dysplasia I

BackgroundDentin dysplasia I (DDI) is a genetically heterogeneous autosomal-dominant disorder characterised by rootless teeth with abnormal pulpal morphology, the aetiology of which presents as genetically heterogeneous.Methods and resultsUsing a cohort...

Ontogenetic Tooth Reduction in Stenopterygius quadriscissus (Reptilia: Ichthyosauria): Negative Allometry, Changes in Growth Rate, and Early Senescence of the Dental Lamina.

We explore the functional, developmental, and evolutionary processes which are argued to produce tooth reduction in the extinct marine reptile Stenopterygius quadriscissus (Reptilia: Ichthyosauria). We analyze the relationship between mandible growth and tooth size, shape, and count, to establish an ontogenetic trend. The pattern in S. quadriscissus is consistent with hypotheses of tooth size reduction by neutral selection, and this unusual morphology (a functionally edentulous rostrum) was produced by a series of different evolutionary developmental changes that are known for other taxa showing tooth reduction and loss. Specifically, this species evolved functional edentulism by evolutionary changes in the growth allometry of the dentition and by altering growth rates through ontogeny. This observation supports previous hypotheses that S. quadriscissus underwent ontogenetic tooth reduction. Tooth reduction in S. quadriscissus may be caused by unique selective pressures resulting from prey choice and feeding behavior, expanding our current understanding of the mechanisms producing tooth reduction.

Infraocclusion: Dental development and associated dental variations in singletons and twins

ObjectiveThe aim of this study was to investigate the prevalence of selected dental variations in association with infraocclusion, as well as determining the effects of infraocclusion on dental development and tooth size, in singletons and twins. DesignTwo samples were analysed. The first sample comprised 1454 panoramic radiographs of singleton boys and girls aged 8–11 years. The second sample comprised dental models of 202 pairs of monozygotic and dizygotic twins aged 8–11 years. Adobe Photoshop CS5 was used to construct reference lines and measure the extent of infraocclusion (in mm) of primary molars on the panoramic radiographs and on 2D images obtained from the dental models. The panoramic radiographs were examined for the presence of selected dental variations and to assess dental development following the Demirjian and Willems systems. The twins’ dental models were measured to assess mesiodistal crown widths. ResultsIn the singleton sample there was a significant association of canines in an altered position during eruption and the lateral incisor complex (agenesis and/or small tooth size) with infraocclusion (P<0.001), but there was no significant association between infraocclusion and agenesis of premolars. Dental age assessment revealed that dental development was delayed in individuals with infraocclusion compared to controls. The primary mandibular canines were significantly smaller in size in the infraoccluded group (P<0.05). ConclusionThe presence of other dental variations in association with infraocclusion, as well as delayed dental development and reduced tooth size, suggests the presence of a pleiotropic effect. The underlying aetiological factors may be genetic and/or epigenetic.

Hedgehog signaling regulates dental papilla formation and tooth size during zebrafish odontogenesis

Background: Intercellular communication by the hedgehog cell signaling pathway is necessary for tooth development throughout the vertebrates, but it remains unclear which specific developmental signals control cell behavior at different stages of odontogenesis. To address this issue, we have manipulated hedgehog activity during zebrafish tooth development and visualized the results using confocal microscopy. Results: We first established that reporter lines for dlx2b, fli1, NF‐κB, and prdm1a are markers for specific subsets of tooth germ tissues. We then blocked hedgehog signaling with cyclopamine and observed a reduction or elimination of the cranial neural crest derived dental papilla, which normally contains the cells that later give rise to dentin‐producing odontoblasts. Upon further investigation, we observed that the dental papilla begins to form and then regresses in the absence of hedgehog signaling, through a mechanism unrelated to cell proliferation or apoptosis. We also found evidence of an isometric reduction in tooth size that correlates with the time of earliest hedgehog inhibition. Conclusions: We hypothesize that these results reveal a previously uncharacterized function of hedgehog signaling during tooth morphogenesis, regulating the number of cells in the dental papilla and thereby controlling tooth size. Developmental Dynamics 244:577–590, 2015. © 2015 Wiley Periodicals, Inc.

Hedgehog signaling regulates dental papilla formation and tooth size during zebrafish odontogenesis.

Intercellular communication by the hedgehog cell signaling pathway is necessary for tooth development throughout the vertebrates, but it remains unclear which specific developmental signals control cell behavior at different stages of odontogenesis. To address this issue, we have manipulated hedgehog activity during zebrafish tooth development and visualized the results using confocal microscopy. We first established that reporter lines for dlx2b, fli1, NF-κB, and prdm1a are markers for specific subsets of tooth germ tissues. We then blocked hedgehog signaling with cyclopamine and observed a reduction or elimination of the cranial neural crest derived dental papilla, which normally contains the cells that later give rise to dentin-producing odontoblasts. Upon further investigation, we observed that the dental papilla begins to form and then regresses in the absence of hedgehog signaling, through a mechanism unrelated to cell proliferation or apoptosis. We also found evidence of an isometric reduction in tooth size that correlates with the time of earliest hedgehog inhibition. We hypothesize that these results reveal a previously uncharacterized function of hedgehog signaling during tooth morphogenesis, regulating the number of cells in the dental papilla and thereby controlling tooth size.

Prosthetic treatment of nonsyndromic oligodontia

Oligodontia is the agenesis of six or more teeth, excluding the third molars. Genetic factors play an important role in oligodontia, which can occur as an isolated finding or as part of a syndrome. The characteristic dental symptoms are reduced number of teeth, reduction in tooth size, anomalies of tooth form, and delayed eruption. The absence of teeth in patients can cause aesthetic, functional, and psychological problems, particularly if the anterior region is involved. This case report describes the prosthetic treatment approach to a 19-year-old patient with nonsyndromic oligodontia characterized by the absence of 10 permanent teeth. The objectives of the treatment were the prosthetic restoration of the missing teeth and the provision of occlusion with full-mouth zirconia restorations.