Dental Development in Children and Its Influences on Craniofacial Morphology

The relationship between dental development and facial morphology has been a point of interest for dental care professionals. In this thesis, we investigated the patterns of child’s dental development by analyzing the effects of genetic, endocrine and other dental determinants. Further, we explored the influence of dental determinants on craniofacial morphology in children. All studies published in this thesis were embedded in the Generation R Study, a population-based prospective cohort from fetal life until young adulthood. The rationale an

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Objectives: In this cross-sectional study, we aimed to investigate the pattern of hypodontia in the Dutch population and determine the association between hypodontia and dental development in children with and without hypodontia, applying three different standards, Dutch, French Canadian, and Belgian, to estimate dental age. Methods: We used dental panoramic radiographs (DPRs) of 1488 children (773 boys and 715 girls), with a mean age of 9.76 years (SD = 0.24) participating in a population-based cohort study in Rotterdam, the Netherlands, born in 2002–2004, and 452 children (219 boys and 233 girls) with a mean age of 9.83 years (SD = 1.09) participating in a mixed-longitudinal, interdisciplinary population-based cohort study in Nijmegen, the Netherlands born in 1960–1968. Results: The prevalence of hypodontia in the Generation R Study was 5.6 % (N = 84) and 5.1 % (N = 23) in the Nijmegen Growth Study. Linear regression analysis showed that children with hypodontia had a 0.37 [95 % CI (−0.53,-0.21)] to 0.52 [95 % CI (−0.76,-0.38)] years lower dental age than children without hypodontia. The ordinal regression analysis showed a delay in development of mandibular second premolars [1.68 years; 95 %CI (−1.90,-1.46)], mandibular first premolars [0.57 years; 95 % CI (−0.94,-0.20)], and mandibular second molars [0.47 years; 95 % CI (−0.84,-0.11)]. Conclusion: These findings suggest that children with hypodontia have a delayed dental development. Clinical relevance: The delay of dental development in children with hypodontia should be taken into consideration and therefore orthodontists should recognize that a later start of treatment in these patients may be necessary

Ancestry and dental development: A geographic and genetic perspective

Objective: In this study, we investigated the influence of ancestry on dental development in the Generation R Study. Methods: Information on geographic ancestry was available in 3,600 children (1,810 boys and 1,790 girls, mean age 9.81±0.35 years) and information about genetic ancestry was available in 2,786 children (1,387 boys and 1,399 girls, mean age 9.82±0.34 years). Dental development was assessed in all children using the Demirjian method. The associations of geographic ancestry (Cape Verdean, Moroccan, Turkish, Dutch Antillean, Surinamese Creole and Surinamese Hindustani vs Dutch as the reference group) and genetic content of ancestry (European, African or Asian) with dental development was analyzed using linear regression models. Results: In a geographic perspective of ancestry, Moroccan (β=0.18; 95% CI: 0.07, 0.28), Turkish (β=0.22; 95% CI: 0.12, 0.32), Dutch Antillean (β=0.27; 95% CI: 0.12, 0.41), and Surinamese Creole (β=0.16; 95% CI: 0.03, 0.30) preceded Dutch children in dental development. Moreover, in a genetic perspective of ancestry, a higher proportion of European ancestry was associated with decelerated dental development (β=-0.32; 95% CI: -.44, -.20). In contrast, a higher proportion of African ancestry (β=0.29; 95% CI: 0.16, 0.43) and a higher proportion of Asian ancestry (β=0.28; 95% CI: 0.09, 0.48) were associated with accelerated dental development. When investigating only European children, these effect estimates increased to twice as large in absolute value. Conclusion: Based on a geographic and genetic perspective, differences in dental development exist in a population of heterogeneous ancestry and should be considered when describing the physiological growth in children

Rare and Common Variants Conferring Risk of Tooth Agenesis

We present association results from a large genome-wide association study of tooth agenesis (TA) as well as selective TA, including 1,944 subjects with congenitally missing teeth, excluding third molars, and 338,554 controls, all of European ancestry. We also tested the association of previously identified risk variants, for timing of tooth eruption and orofacial clefts, with TA. We report associations between TA and 9 novel risk variants. Five of these variants associate with selective TA, including a variant conferring risk of orofacial clefts. These results contribute to a deeper understanding of the genetic architecture of tooth development and disease. The few variants previously associated with TA were uncovered through candidate gene studies guided by mouse knockouts. Knowing the etiology and clinical features of TA is important for planning oral rehabilitation that often involves an interdisciplinary approach

Comparative analysis of linear morphometric parameters of the humane mandibula obtained by direct and indirect measurement

Background/Aim. Reconstruction of lost, damaged or distorted mandibular bone presents a challenge from the functional side, as well as from the esthetic point of view. The aim of this study was to determinate potential differences between values of the basic linear moprhometric parameters (LMPs) obtained by direct and indirect manual measurement of the same humane mandibles, with accuracy testing of indirect measurement, which are routinely used in every-day clinical practice. The results are essential for defining of parametric model of the 'standard mandible' and virtual modeling of the humane mandible in future researches as well as in clinical medicine. Methods. A total number of 12 dry bony mandibles of human adults were studied. According to the standard anatomical landmarks, 10 standard LPMs were measured on each mandible by different manual methods: directly by a sliding caliper with nonius, and indirectly using standard software on two-dimensional (2D) reconstructions of mandibular multislice computed tomography (MSCT) scans. The values obtained by the different measuring methods were matched for the same LMPs. Results. Statistically significant differences between compared LMPs values obtained by different measuring methods, appeared in the gnathio-interdental distance (Gn-IdD), as well as in the gnathio-condylar distance (Gn-CoD), bilaterally. In both parameters, significantly higher mean values (with percent of difference) were obtained by direct versus indirect measurement: Gn-IdD (21.57%; 29.2 mm vs 22.9 mm; p = 0.004); Gn-CoD left side (14.1%; 122.7 mm vs 105.4 cm; p = 0.001); Gn-CoD right side (11.87%; 124.7 mm vs 109.9 mm; p = 0.009). Conclusion. According to the observed inaccuracy of indirect measurement, we recommended the use of a correction factor for calculation of both Gn-IdD and Gn-CoD real vales, in defining of parametric model of the 'standard mandible' based on indirect morphometry on 2D reconstructions of mandibular MSCT scans. Additional studies with larger number of specimens and quantification of anatomical variations regarding to sex, age, dentition status and ethnic origin, additionally should increase measurement accuracy and consequently reliability of future parametric model of the human mandible