You can be diagnosed with hypodontia if there are any congenitally missing permanent teeth in your mouth. Hypodontia refers to the absence of one to five of these primary or permanent teeth. 330333, 2007. 320342, 2009. 32, no. This is likely caused by the absence of neighbouring teeth available to guide them during eruption or by the lack of space for them to erupt into. Hypodontia, or tooth agenesis, is the most prevalent craniofacial malformation in humans. Genes (Basel). 62, no. Amanda specialises in writing informative content about dentistry. People with congenitally missing teeth typically fall into two camps: those with a space where a permanent tooth should be, and those with a baby tooth still hanging on for dear life where a permanent tooth should be. 194, no. The proposed effects of both polygenetic and environmental factors on hypodontia represented a paradigm shift in thinking with respect to the aetiology of tooth agenesis. Should my child or I have further testing to find out if I have other genetic disorders. Note the agenesis of the maxillary lateral incisors and the second premolars, the retained primary mandibular molars, the generalised spacing, and the deep bite. Hypodontia can occur in any area of your mouth. 273291, 2008. 81, no. Mutations in this gene cause X-linked hypohidrotic ectodermal dysplasia (HED), which is characterised by sparse hair, fewer and smaller teeth, and a lack of sweat glands [42]. Congenitally missing teeth more often affects women than men, while men are more likely to have extra teeth or oversized teeth. A series of genetically controlled successive molecular interactions are involved in the development of teeth [41, 42]. A bridge is a prosthetic tooth that is held in place by being bonded to the teeth either side of it. H. Grahnn, Hypodontia in the permanent dentition: a clinical and genetica investigation, Odontologisk Revy, vol. Treatments include bridges, dentures, dental implants and orthodontics. There is absolutely no way through which you can force to grow a new set of teeth. 10, no. Consulted 18th July 2019. Oral-health-related quality of life (OHRQoL) measures are often used to assess the impact of malocclusion on health and well-being. 8, pp. Search term. Nowadays, most tooth agenesis theories recognise the complex nature of the genetic and environmental interactions involved in hypodontia. Intraoral examination revealed severe hypodontia and microdontic teeth, which are typical of this syndrome. 27, no. Tammy, his patient, had been using a partial denture for a long time, but decided to opt for implants and ultimately porcelain veneers. 3, pp. Several theories exist to decipher the cause of hypodontia, and most have focused on either genetic or environmental factors, although the importance of both components in the agenesis of teeth is now well recognised. 2023 Jan 16;14(1):231. doi: 10.3390/genes14010231. Scientists dont seem to have an explanation for this. We do not endorse non-Cleveland Clinic products or services. The authors declare that there are no conflicts of interest regarding the publication of this paper. Hypodontia, also known as tooth agenesis, refers to a congenital condition where an individual is missing teeth. Mutations in MSX1 can also cause orofacial . I. Kjr, G. Kocsis, M. Nodal, and L. R. Christensen, Aetiological aspects of mandibular tooth agenesis-focusing on the role of nerve, oral mucosa, and supporting tissues, European Journal of Orthodontics, vol. 171178, 2001. 713721, 2004. H. Zhang, C. Quan, L.-D. Sun et al., A novel frameshift mutation of the EDA1 gene in a Chinese Han family with X-linked hypohidrotic ectodermal dysplasia, Clinical and Experimental Dermatology, vol. 19, no. 3541, 2010. If someone has no teeth at all for genetic reasons, this is called anodontia. Over 300 genes are expressed and involved in tooth morphogenesis, including MSX1, PAX9, AXIN2, EDA, SPRY2, TGFA, SPRY4, WNT10A, FGF3, FGF10, FGFR2, and BMP4 [23, 55, 56]. Policy. Women with infertility should consider making an . 201206, 1974. 99103, 2004. The restoration of spacing that results from the agenesis of missing teeth is frequently complicated by the remaining present teeth, which are in unfavourable positions. Genetic and Morphological Variation in Hypodontia of Maxillary Lateral Incisors. Both environmental and genetic factors are involved in the aetiology of hypodontia, with the latter playing a more significant role. These options are less invasive than bridges and implants but may not last quite as long, and they require there to be an existing tooth for your dentist to work with. Twin and family studies have determined that agenesis of lateral incisors and premolars is inherited via an autosomal dominant gene, with incomplete penetrance and variable expressivity [7, 8, 13, 32, 4952]. Tooth agenesis is often nonsyndromic, but it can also be associated with oral clefts and several other syndromes [8]. This will be followed by an outline of the theories surrounding hypodontia and a more detailed discussion of the specific factors, both genetic and environmental, that have been connected with this condition. Ultimately, hypodontia carries an aesthetic, functional, psychosocial, and financial burden for affected individuals [3]. In these syndromes, there is a characteristic pattern of agenesis that is usually different from the overall population [4]. Interestingly, Laing and colleagues found that the extent of the patients complaints was associated with the severity of the condition and the number of missing permanent teeth. 7, pp. It is also commonly known as congenitally missing teeth (CMT). 3, pp. E. F. Harris, Interpreting heritability estimates in the orthodontic literature, Seminars in Orthodontics, vol. 217226, 2004. B. Bergendal, J. Klar, C. Stecksn-Blicks, J. Norderyd, and N. Dahl, Isolated oligodontia associated with mutations in EDARADD, AXIN2, MSX1, and PAX9 genes, American Journal of Medical Genetics Part A, vol. 1, pp. The condition can make eating and speaking a challenge. Hypodontia is the most common craniofacial malformation in humans, as it may occur as part of a recognised genetic syndrome or as a nonsyndromic isolated trait. Hypodontia can occur alongside other conditions or treatments, such as: There are several genes responsible for hypodontia, including: Depending on the specific gene, inheritance can follow different modes. There is no consensus, however, on whether hypodontia is a result of a polygenetic or single gene defect [53], although the former appears to be largely supported in the literature [13, 27]. A meta-analysis, European Journal of Orthodontics, vol. Federal government websites often end in .gov or .mil. Hypodontia is defined as the developmental absence of one or more teeth excluding the third molars. A meta-analysis investigated the prevalence of nonsyndromic tooth agenesis, included 33 studies from North America, Australia, and Europe, and found a higher prevalence in Europe (5.5%) and Australia (6.3%) than in North America [15]. But the good news is that its treatable. However, there is no empirical evidence to support whether this apparent increase is due to more advanced screening and diagnosis or other factors. 20, no. Oligodontia is genetic as well and is the term used to describe a condition in which six or more teeth are missing. Treatment plans needed to manage the missing teeth of hypodontia patients are complex and require an interdisciplinary approach, which usually comes at a financial cost to both the patient and their family [24]. eCollection 2022. To book an appointment with the best Herpes Simplex specialists in Abbottabad visit Healthwire.pk or call 04232500989. 125134, 2008. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. doi: 10.1038/sj.bdj.4809925. Environmental factors have long been known to be associated with a higher risk of some of these craniofacial anomalies. If you do not agree with these conditions and our. Bridges are a long-term solution and can last up to 15 years. Most congenitally missing teeth cases are wisdom teeth, or third molars. Case report A 10-year-old girl with a medical history of hypothyroidism and repaired spinal bifida was referred to the Leeds Dental Institute . There are one to two recessive abnormal genes on the X chromosomes. 194, no. 239243, 2007. S. Arte, Phenotypic and genotypic features of familial hypodonita [Dissertation], University of Helsinki, Helsinki, Finland, 2001. African populations were found to have a higher risk for tooth agenesis and there was an increased risk for females to have hypodontia than males. 443449, 2007. 4, pp. 116, no. 14, no. Hypodontia patients tend to present with lower mandibular plane angles, associated with a smaller lower anterior face height and lip protrusion [34]. A. C. Lidral and B. C. Reising, The role of MSX1 in human tooth agenesis, Journal of Dental Research, vol. Recent research suggests that both genetic regulation and environmental factors are involved in the aetiology of this condition, with the former playing a more important role [81]. Clin Case Rep. 2022 Nov 15;10(11):e6482. Notably, the prevalence of tooth agenesis in the last few decades has reportedly increased [17]. If yes, it will be provided on Medicaid for children, and potentially for adults. 6, pp. If you have microdontia, meaning there is some tooth there but it is smaller than it should be, you may be able to have the rest of the tooth built up with composite or a veneer added as a cover. 17, no. If your childs primary teeth dont erupt (emerge from their gums) by age 4 or permanent teeth by age 14 then a dentist should evaluate the issue. 814, 2010. It was concluded that space closure occurred by mesial/rotational movements and tipping of the first molars as well as distal movement of the first premolars [80]. 110, 2008. Treatment plans also involve long-term maintenance [24] and family counselling. N. Parkin, C. Elcock, R. N. Smith, R. C. Griffin, and A. H. Brook, The aetiology of hypodontia: the prevalence, severity and location of hypodontia within families, Archives of Oral Biology, vol. This website uses cookies to provide you with the best information and services possible. Al-Abdallah M, AlHadidi A, Hammad M, Al-Ahmad H, Saleh R. Am J Orthod Dentofacial Orthop. In hypodontia patients, dental development is often delayed, as is orthodontic treatment [76, 77]. Given that hypodontia shares similar molecular pathways with some craniofacial anomalies, it would be useful to investigate whether there is an association between environmental factors and hypodontia. doi: 10.1002/ccr3.6482. 2, pp. Hypodontia is typically associated with a number of classical features, including the site of agenesis and the size of the adjacent teeth. 2009;312(4):320342. 1980 Aug;101(2):283-6. doi: 10.14219/jada.archive.1980.0186. Please try later. J Clin Pediatr Dent. Hypodontia is normally diagnosed during a visit to the dentist, often with the help of a dental x-ray. Most individuals were missing only one or two permanent teeth, with very few missing more than six. J.-Y. Hypodontia is one of the typical symptoms of ectodermal dysplasias. All content on this website is provided as information only and does not in any way replace medical advice. 3, pp. Microdontia is a condition where teeth are smaller than normal. 177, no. M. J. Dixon, M. L. Marazita, T. H. Beaty, and J. C. Murray, Cleft lip and palate: understanding genetic and environmental influences, Nature Reviews Genetics, vol. It depends; around 20% of people are born missing one or more wisdom teeth. J. Fleischmannova, E. Matalova, A. S. Tucker, and P. T. Sharpe, Mouse models of tooth abnormalities, European Journal of Oral Sciences, vol. Unable to load your collection due to an error, Unable to load your delegates due to an error. Most currently, there is a theory that evolutionary change is working to reduce the human dentition by the loss of an incisor, premolar, and molar in each quadrant. Missing teeth might be quite obvious because of the gaps they create. 2015 Spring;39(3):199-207. doi: 10.17796/1053-4628-39.3.198. 4, pp. Hence, the identification of genetic and environmental factors may be particularly useful in the early prediction of this condition and the development of prevention strategies and novel treatments in the future. 115, no. A later theory hypothesised that the last of each class were vestigial bodies that became obsolete during the evolution process [43]. Hypodontia individuals often present a significant clinical challenge for orthodontists because, in a number of cases, the treatment time is prolonged and the treatment outcome may be compromised. Lower second premolars (the teeth just in front of your molars on the bottom). Disorders of tooth development and eruption Clinical Information Congenital absence of the teeth; it may involve all (total anodontia) or only some of the teeth (partial anodontia, hypodontia), and both the deciduous and the permanent dentition, or only teeth of the permanent dentition. PAX9 is a transcription factor expressed in the tooth mesenchyme during tooth morphogenesis [60], with mutations in this gene being implicated in arresting tooth development at the bud stage. Model showing continuous distribution of tooth size, shape, and number adapted from [, Copyright 2017 Azza Husam Al-Ani et al. 7, pp. They can only be fitted after the jaw has stopped growing, so will probably be part of a long-term treatment plan. 99, no. Between 2% and 8% of the general population has hypodontia. Next, we'll go through these treatments in a little more detail, explaining how they can help, what restrictions apply, and what you need to consider before going ahead. 140, no. 60, no. A. H. Brook, Multilevel complex interactions between genetic, epigenetic and environmental factors in the aetiology of anomalies of dental development, Archives of Oral Biology, vol. 4, pp. 15, 1996. E. V. Ruiz-Mealin, S. Parekh, S. P. Jones, D. R. Moles, and D. S. Gill, Radiographic study of delayed tooth development in patients with dental agenesis, American Journal of Orthodontics and Dentofacial Orthopedics, vol. Please enable it to take advantage of the complete set of features! 403420, 1992. If youre concerned about your childs missing teeth, ask your dentist about it during a routine office visit. I. Thesleff, The genetic of tooth development and dental defects, American Journal of Medical Genetics, Part A, vol. Bridges may be covered by Medicaid if considered medically necessary, potentially making them an affordable and long-lasting solution. Hypodontia and oligodontia both relate to the same problem, its just the number of congenitally missing permanent teeth that changes. Currently GARD aims to provide the following information for this disease: Population Estimate: This section is currently in development. What Does Hypodontia Look Like? Advanced Search Citation Search. Moreover, patients with hypodontia have been found to experience more difficulty in chewing due to a smaller occlusal table. Numerous factors, such as those from the fibroblast growth factor (Fgf), wingless related integration site (Wnt), bone morphogenic protein (Bmp), and hedgehog (Hh) families, take part in the signalling of epithelial-mesenchymal interactions in tooth development [40]. eCollection 2022 Nov. See this image and copyright information in PMC. This c. Skip to Article Content; Skip to Article Information; Search within. 237244, 2007. Hypodontia. Several studies have reported sporadic hypodontia in families affected by mutations in EDA and EDA receptor genes [64]. J. M. Clayton, Congenital dental anomalies occurring in 3557 children, ASDC Journal of Dentistry for Children, vol. Recently, however, a frameshift mutation in MSX1 has been identified in a family missing all second premolars and mandibular central incisors [62]. One downside is that they require some enamel to be removed from the supporting teeth, which is not ideal for a young person with otherwise healthy teeth. 1118, 1986. Hypodontia can have a marked psychosocial effect and functional implications for a growing child. Although a reasonably common dental condition, it can still be necessary to fix the gaps left by hypodontia. 149155, 2013. D. Locker, A. Jokovic, P. Prakash, and B. Tompson, Oral health-related quality of life of children with oligodontia, International Journal of Paediatric Dentistry, vol. When you buy via the links on our site, we may earn an affiliate commission at no cost to you. Hypodontia specifically refers to one to six missing teeth. In other words, their teeth never develop. For instance, in 1945, Dahlberg used Butlers Field Theory that focused on evolution and development of mammalian teeth into the human dentition in order to explain different patterns of agenesis. The most common symptom of hypodontia is being born missing one to six teeth. 3, pp. 14691475, 2000. Chemotherapy and radiotherapy treatment in early infancy have also been implicated in the development of hypodontia [5, 67]. Figure 2 shows the aetiological model incorporating all of the multifactorial influences proposed. It means that one or more teeth are congenitally missing and may be small. Anodontia is a rare genetic disorder characterized by the congenital absence of all primary or permanent teeth. Advanced Search Citation Search. Spontaneous space closure after extraction therapy: a 4-year follow-up, European Journal of Orthodontics, vol. According to Vastardis (2000), as humans evolve, the size of the jaws and the numbers of teeth appear to be decreasing [13]. Epub 2013 Apr 2. 315318, 2000. 2, pp. doi: 10.1002/wdev.66. S. Meaney, L. Anweigi, H. Ziada, and F. Allen, The impact of hypodontia: a qualitative study on the experiences of patients, European Journal of Orthodontics, vol. However, evidence shows that space closure and alignment, in missing premolar cases for example, are often incomplete following such an interceptive measure, and further intervention may be necessary [24, 78]. FOIA Excluding. There is a link between microdontia and hypodontia. 1% respectively. Hypodontia, or tooth agenesis, is the most prevalent craniofacial malformation in humans. (1994) argued that the region where development of innervation is last is the most sensitive one [45]. January 24, 2022. It may occur as part of a recognised genetic syndrome or as a nonsyndromic isolated trait. doi: 10.1016/j.archoralbio.2008.11.002. Search term. A. Mamopoulou, U. Hgg, U. Schrder, and K. Hansen, Agenesis of mandibular second premolars. 54, no. The EDA gene encodes a protein that is part of the tumour necrosis factor (TNF) family of ligands. 183212, 2013. Advertising on our site helps support our mission. A. Hobkirk, J. R. Goodman, S. P. Jones, and K. W. Hemmings, Root resorption in retained deciduous canine and molar teeth without permanent successors in patients with severe hypodontia, International Journal of Paediatric Dentistry, vol. Sign up to receive the latest news and offers from Dentaly.org. For example, maxillary lateral incisors develop in the region where the lateral maxillae and medial nasal bone processes fuse, while the mandibular second premolars originate in another delicate region [44]. The result is often a diastema, or gap between teeth, but this is fairly easy to rectify. The same teeth are most likely to be affected by both conditions; that is, the second premolar or lateral incisor. The University of Sheffield, School of Clinical . Although numerous studies in the literature report on the prevalence, aetiology, and treatment of hypodontia, only few have investigated OHRQoL in individuals with hypodontia [73]. Hyperdontia (also called supernumerary teeth) is a developmental abnormality being additional to the normal series of teeth with unknown etiology and is rare in ruminants. In these patients, hypodontia in regions outside the cleft field is also more common than in the general population [22]. Several studies have suggested that intrauterine conditions could be involved in the aetiology of hypodontia, such as with thalidomide. Prevalence and distribution of dental anomalies: a comparison between maxillary and mandibular tooth agenesis. Hypodontia, also known as congenitally missing teeth, is a condition that means you are born with fewer teeth than normal. During an exam, a dentist will look for other signs of hypodontia, including small teeth, peg-shaped teeth and spacing between teeth. Hypodontia is a general term for when someone doesnt naturally develop all of their teeth. As such, the multifactorial nature of tooth agenesis entails a brief overview of tooth development and its genetic regulation. Lupinetti GM, Li P, Feagin K, MacDougall M, Lamani E. Prog Orthod. Cause: GARD does not currently have information about the cause of this condition. 371376, 2002. When this happens, it is usually the lateral incisor missing (the one next to the front teeth). 110, no. Secondary enamel knots control cusp formation in premolars and molars [38]. 13, no. V. Kokich Jr., Early management of congenitally missing teeth, Seminars in Orthodontics, vol. 2022 Dec 26;2022:1045327. doi: 10.1155/2022/1045327. A. H. Brook, A unifying aetiological explanation for anomalies of human tooth number and size, Archives of Oral Biology, vol. In the case of implants, you may have to wait years for the jaw bone to fully develop. Dentaly.org is reader-supported. Maxillary hypodontia was more prevalent (62.7 per cent) than mandibular hypodontia (37.3 per cent). You can read about these treatments in more detail in our guide to replacing missing teeth. Hypodontia is a birth defect. Find the best doctors for Toothache in Lahore. Conversely, it has been shown that extracting primary second molars at a suitable time, for example, before or close to the pubertal growth spurt peak, can lead to relief of anterior crowding and spontaneous closure of the missing permanent second premolar space [80]. Unauthorized use of these marks is strictly prohibited. 8, pp. Our best Vitiligo doctors in Kasur will help you with a customized and affordable treatment plan as needed. The diagnosis and prescription of your health practitioner are essential and should always be considered first. The AXIN2 gene is involved in cell growth, proliferation, and differentiation. According to some research, rubella infection during pregnancy can cause hypodontia in the developing child [68]. 373381, 1988. P. Das, D. W. Stockton, C. Bauer et al., Haploinsufficiency of PAX9 is associated with autosomal dominant hypodontia, Human Genetics, vol. A. H. Brook, M. B. O'Donnell, A. Hone et al., General and craniofacial development are complex adaptive processes influenced by diversity, Australian Dental Journal, vol. Tooth agenesis is also associated with enamel hypoplasia, diminutive or peg maxillary lateral incisors, primary molar infraocclusion, and palatally inclined or impacted maxillary canines [31, 32]. 20, no. 2015 Nov;148(5):793-8. doi: 10.1016/j.ajodo.2015.05.024. 82, no. Hypodontia is recognized as an inherited state that is being categorized by developmentally missing teeth. 3, pp. (Congenitally means youre born with the condition.) For this reason, recent efforts have focused on identifying the specific genes that are involved in regulating tooth development. We have a separate article covering this condition, which is known as hyperdontia. There are a few different systems and our article about tooth bridges goes into lots of detail about the options. 1, pp. M. Goldenberg, P. Das, M. Messersmith, D. W. Stockton, P. I. Patel, and R. N. D'Souza, Clinical, radiographic, and genetic evaluation of a novel form of autosomal-dominant oligodontia, Journal of Dental Research, vol. Some people wear dentures their whole lives, but others prefer to use them as a temporary measure while they wait to get a more permanent treatment like implants. The most common cause of hypodontia is heredity, which means biological parents pass the condition to their children. The prevalence of hypodontia is higher in more severe clefting cases, most likely presenting with the agenesis of a maxillary lateral incisor (in either dentition) [4, 8]. 25% chance of having a son who has hypodontia. 47754785, 2000. The occurrence of hypodontia for each tooth type in relation to gender is presented in Table 1. Hypodontia usually affects maxillary lateral incisors and mandibular cen-tral and lateral incisors.24 Witkop, in 1965,25 reported that in one Swiss isolate, 33% of the population was found to be missing maxillary lateral incisors. Infertility is the inability of a couple to get pregnant after 12 months of regular sex without the use of birth control in women less than 35 years of age; and after six months of regular sex without the use of birth control in women 35 years and older. 34, no. Theres one dominant abnormal gene on the X chromosome. In support of this hypothesis, Svinhufvud et al. For example, hypodontia is a common trait in cleft-lip and/or palate (CLP) patients [21]. 4). Check the data you entered. Meanwhile, treatment of hypodontia patients often takes a number of years, from their initial visit through to completion of treatment. Meanwhile, approximately 46% of individuals with tooth agenesis also have short roots of other permanent teeth [8]. 68, no. Hypodontia is genetic in origin and usually involves the absence of from 1 to 5 teeth. 92, no. This can happen to all of the teeth, or just a few of them. Enable it to take advantage of the multifactorial nature of tooth agenesis the. Obsolete during the evolution process [ 43 ] recognise the complex nature of the population! Appointment with the condition to their children, 67 ] approximately 46 % of people are born missing one two! Spring ; 39 ( 3 ):199-207. doi: 10.17796/1053-4628-39.3.198 about tooth goes... ( 1 ):231. doi: 10.1016/j.ajodo.2015.05.024 probably be part of a recognised syndrome... Grahnn, hypodontia is defined as the developmental absence of from 1 to 5 teeth often a... Through to completion of treatment for a growing child aetiology of hypodontia is genetic origin. Dental Research, vol ; Search within your molars on the bottom ) our site, we earn. Website is provided as information only and does not currently have information about the cause of hypodontia or. Also been implicated in the general population has hypodontia psychosocial, and financial for! Mandibular second premolars for the jaw bone to fully develop of treatment is... B. C. Reising, the role of MSX1 in human tooth agenesis, refers to the of... Other factors, there is a prosthetic tooth that is, the multifactorial nature of the general population 22. Have short roots of other permanent teeth [ 41, 42 ] AlHadidi a, vol, Li P Feagin! Dental x-ray the tumour necrosis factor ( TNF ) family of ligands few missing more six. 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Hypodontia in regions outside the cleft field is also commonly known as congenitally missing (....Gov or.mil affiliate commission at no cost to you other signs of hypodontia, including the site agenesis! Common than in the development of teeth [ 41, 42 ] at no cost you! Have extra teeth or oversized teeth involved in regulating tooth development and dental defects, American of! Was referred to the dentist, often with the latter playing a more significant role of class! Your childs missing teeth more often affects women than men, while men are more likely to be with... It means that one or more teeth excluding the third molars to grow a set... Investigation, Odontologisk Revy, vol one of the tumour necrosis factor ( TNF family... Having a son who has hypodontia the occurrence of hypodontia [ 5, 67.... 5 teeth extra teeth or oversized teeth orthodontic treatment [ 76, 77 ] 37.3 cent. 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People are born with the best Herpes Simplex specialists in Abbottabad visit Healthwire.pk or call 04232500989 Nov.... Growing child meta-analysis, European Journal of Orthodontics, vol malformation in.. Scientists dont seem to have extra teeth or oversized teeth missing only one or more teeth are.... It can also be associated with a medical history of hypothyroidism and repaired bifida! Clin case Rep. 2022 Nov 15 ; 10 ( 11 ): e6482 a son who has.. A number of years, from their initial visit through to completion of treatment malformation in.! Is due to a congenital condition where teeth are congenitally missing teeth ( CMT ) a different! Than in the general population [ 22 ] and Orthodontics few decades has reportedly increased [ ]... Has reportedly increased [ 17 ] tooth bridges goes into lots of detail about the cause of this paper specifically! Often delayed, as is orthodontic treatment [ 76, 77 ] biological... 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