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The Cochrane Database of Systematic... May 2020Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is the surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local...
BACKGROUND
Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is the surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is performed in older people, the risk of postoperative complications, pain and discomfort is increased. Other reasons to justify prophylactic removal of asymptomatic disease-free impacted third molars have included preventing late lower incisor crowding, preventing damage to adjacent structures such as the second molar or the inferior alveolar nerve, in preparation for orthognathic surgery, in preparation for radiotherapy or during procedures to treat people with trauma to the affected area. Removal of asymptomatic disease-free wisdom teeth is a common procedure, and researchers must determine whether evidence supports this practice. This review is an update of an review originally published in 2005 and previously updated in 2012 and 2016.
OBJECTIVES
To evaluate the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth in adolescents and adults.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 May 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2019, Issue 4), MEDLINE Ovid (1946 to 10 May 2019), and Embase Ovid (1980 to 10 May 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov)and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. .
SELECTION CRITERIA
We included randomised controlled trials (RCTs), with no restriction on length of follow-up, comparing removal (or absence) with retention (or presence) of asymptomatic disease-free impacted wisdom teeth in adolescents or adults. We also considered quasi-RCTs and prospective cohort studies for inclusion if investigators measured outcomes with follow-up of five years or longer.
DATA COLLECTION AND ANALYSIS
Eight review authors screened search results and assessed the eligibility of studies for inclusion according to the review inclusion criteria. Eight review authors independently and in duplicate conducted the risk of bias assessments. When information was unclear, we contacted the study authors for additional information.
MAIN RESULTS
This review update includes the same two studies that were identified in our previous version of the review: one RCT with a parallel-group design, which was conducted in a dental hospital setting in the United Kingdom, and one prospective cohort study, which was conducted in the private sector in the USA. Primary outcome No eligible studies in this review reported the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth on health-related quality of life Secondary outcomes We found only low- to very low-certainty evidence of the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth for a limited number of secondary outcome measures. One prospective cohort study, reporting data from a subgroup of 416 healthy male participants, aged 24 to 84 years, compared the effects of the absence (previous removal or agenesis) against the presence of asymptomatic disease-free impacted wisdom teeth on periodontitis and caries associated with the distal aspect of the adjacent second molar during a follow-up period of three to over 25 years. Very low-certainty evidence suggests that the presence of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting the adjacent second molar in the long term. In the same study, which is at serious risk of bias, there is insufficient evidence to demonstrate a difference in caries risk associated with the presence or absence of impacted wisdom teeth. One RCT with 164 randomised and 77 analysed adolescent participants compared the effect of extraction with retention of asymptomatic disease-free impacted wisdom teeth on dimensional changes in the dental arch after five years. Participants (55% female) had previously undergone orthodontic treatment and had 'crowded' wisdom teeth. No evidence from this study, which was at high risk of bias, was found to suggest that removal of asymptomatic disease-free impacted wisdom teeth has a clinically significant effect on dimensional changes in the dental arch. The included studies did not measure any of our other secondary outcomes: costs, other adverse events associated with retention of asymptomatic disease-free impacted wisdom teeth (pericoronitis, root resorption, cyst formation, tumour formation, inflammation/infection) and adverse effects associated with their removal (alveolar osteitis/postoperative infection, nerve injury, damage to adjacent teeth during surgery, bleeding, osteonecrosis related to medication/radiotherapy, inflammation/infection).
AUTHORS' CONCLUSIONS
Insufficient evidence is available to determine whether asymptomatic disease-free impacted wisdom teeth should be removed or retained. Although retention of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is very low certainty. Well-designed RCTs investigating long-term and rare effects of retention and removal of asymptomatic disease-free impacted wisdom teeth, in a representative group of individuals, are unlikely to be feasible. In their continuing absence, high quality, long-term prospective cohort studies may provide valuable evidence in the future. Given the current lack of available evidence, patient values should be considered and clinical expertise used to guide shared decision-making with people who have asymptomatic disease-free impacted wisdom teeth. If the decision is made to retain these teeth, clinical assessment at regular intervals to prevent undesirable outcomes is advisable.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asymptomatic Diseases; Female; Humans; Male; Middle Aged; Molar, Third; Prospective Studies; Randomized Controlled Trials as Topic; Tooth Extraction; Tooth, Impacted; Watchful Waiting
PubMed: 32368796
DOI: 10.1002/14651858.CD003879.pub5 -
Health Technology Assessment... Jun 2020Impacted third molars are third molars that are blocked, by soft tissue or bone, from fully erupting through the gum. This can cause pain and disease. The treatment...
BACKGROUND
Impacted third molars are third molars that are blocked, by soft tissue or bone, from fully erupting through the gum. This can cause pain and disease. The treatment options for people with impacted third molars are removal or retention with standard care. If there are pathological changes, the current National Institute for Health and Care Excellence guidance states that the impacted third molar should be removed.
OBJECTIVE
The objective of this study was to appraise the clinical effectiveness and cost-effectiveness of the prophylactic removal of impacted mandibular third molars compared with retention of, and standard care for, impacted third molars.
METHODS
Five electronic databases were searched (1999 to 29 April 2016) to identify relevant evidence [The Cochrane Library (searched 4 April 2016 and 29 April 2016), MEDLINE (searched 4 April 2016 and 29 April 2016), EMBASE (searched 4 April 2016 and 29 April 2016), EconLit (searched 4 April 2016 and 29 April 2016) and NHS Economic Evaluation Database (searched 4 April 2016)]. Studies that compared the prophylactic removal of impacted mandibular third molars with retention and standard care or studies that assessed the outcomes from either approach were included. The clinical outcomes considered were pathology associated with retention, post-operative complications following extraction and adverse effects of treatment. Cost-effectiveness outcomes included UK costs and health-related quality-of-life measures. In addition, the assessment group constructed a de novo economic model to compare the cost-effectiveness of a prophylactic removal strategy with that of retention and standard care.
RESULTS
The clinical review identified four cohort studies and nine systematic reviews. In the two studies that reported on surgical complications, no serious complications were reported. Pathological changes due to retention of asymptomatic impacted mandibular third molars were reported by three studies. In these studies, the extraction rate for retained impacted mandibular third molars varied from 5.5% to 31.4%; this variation can be explained by the differing follow-up periods (i.e. 1 and 5 years). The findings from this review are consistent with the findings from previous systematic reviews. Two published cost-effectiveness studies were identified. The authors of both studies concluded that, to their knowledge, there is currently no economic evidence to support the prophylactic removal of impacted mandibular third molars. The results generated by the assessment group's lifetime economic model indicated that the incremental cost-effectiveness ratio per quality-adjusted life-year gained for the comparison of a prophylactic removal strategy with a retention and standard care strategy is £11,741 for people aged 20 years with asymptomatic impacted mandibular third molars. The incremental cost per person associated with prophylactic extraction is £55.71, with an incremental quality-adjusted life-year gain of 0.005 per person. The base-case incremental cost-effectiveness ratio per quality-adjusted life-year gained was found to be robust when a range of sensitivity and scenario analyses were carried out.
LIMITATIONS
Limitations of the study included that no head-to-head trials comparing the effectiveness of prophylactic removal of impacted mandibular third molars with retention and standard care were identified with the assessment group model that was built on observational data. Utility data on impacted mandibular third molars and their symptoms are lacking.
CONCLUSIONS
The evidence comparing the prophylactic removal of impacted mandibular third molars with retention and standard care is very limited. However, the results from an exploratory assessment group model, which uses available evidence on symptom development and extraction rates of retained impacted mandibular third molars, suggest that prophylactic removal may be the more cost-effective strategy.
FUTURE WORK
Effectiveness evidence is lacking. Head-to-head trials comparing the prophylactic removal of trouble-free impacted mandibular third molars with retention and watchful waiting are required. If this is not possible, routine clinical data, using common definitions and outcome reporting methods, should be collected.
STUDY REGISTRATION
This study is registered as PROSPERO CRD42016037776.
FUNDING
This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 24, No. 30. See the NIHR Journals Library website for further project information.
Topics: Cost-Benefit Analysis; Humans; Molar, Third; Treatment Outcome; United Kingdom
PubMed: 32589125
DOI: 10.3310/hta24300 -
Journal of Oral and Maxillofacial... Nov 2023Mandibular second molar (M2M) impaction is a serious eruption disorder. The purpose of this systematic review was to analyze the therapeutic approaches for M2M... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Mandibular second molar (M2M) impaction is a serious eruption disorder. The purpose of this systematic review was to analyze the therapeutic approaches for M2M impaction. The objective of the meta-analysis was to summarize the success of the surgical, surgical-orthodontic, and orthodontic treatment.
METHODS
A PRISMA-guided search strategy was conducted by 2 authors in 5 databases up to January 2023. Randomized and nonrandomized clinical trials were considered. Case reports, case series with<5 patients, and reviews were excluded. Methodological quality was assessed using Newcastle-Ottawa scale and Cochrane Collaboration tool for nonrandomized and randomized clinical trials, respectively. Outcomes were as follows: 1) treatment success rate defined by the repositioning of impacted M2M in the dental arch with normal functional occlusal relationship and periodontal health; 2) time-to-repositioning as time-to-event analysis; and 3) complications. Meta-analysis examined treatment success differences with 3 approaches: orthodontic (uprighting maneuvers/traction), surgical (surgical procedures/strategic extractions), and surgical-orthodontic (combined surgical and orthodontic procedures) as the exposure variable. The quantitative analysis also compared the success rate using third molar removal as the secondary predictor variable. The χ test determined the statistical heterogeneity (I2); a cut-off of 70% was used to select the common or random effects model. Odds ratio (OR) and 95% confidence interval (CI) were recorded.
RESULTS
A total of 1,102 articles were retrieved. After full-text reading, 16 articles were included and 1008 M2Ms were analyzed. Nine studies had fair quality, 6 studies had good quality, and 1 had unclear risk of bias. Managing impacted M2Ms showed a moderate to high success rate (66.7 to 100%). Significant differences favoring surgical treatment over orthodontic treatment were observed for M2M uprighting (OR = 4.97; CI: 1.49 to 16.51; P = .01).No differences were detected comparing surgical and surgical-orthodontic treatment (OR = 1.00; CI: 0.03 to 37.44; P = .99), or orthodontic and surgical-orthodontic treatment(OR = 4.14; CI: 0.43 to 40.14; P = .22).Third molar removal showed no significant correlation with M2M uprighting (OR = 1.98; CI: 0.24 to 16.03; P = .5).
CONCLUSION
Despite study limitations, both orthodontic and surgical management of impacted M2M can be effective suggesting that clinicians are able to choose best treatment for most cases.
Topics: Humans; Molar; Tooth Extraction; Dental Care; Tooth, Impacted; Molar, Third
PubMed: 37699532
DOI: 10.1016/j.joms.2023.08.168 -
Oral Oncology Mar 2022There is a wide range of commercial and custom-made devices available for the treatment of trismus (restricted jaw opening). They are used often in conjunction with a... (Review)
Review
BACKGROUND
There is a wide range of commercial and custom-made devices available for the treatment of trismus (restricted jaw opening). They are used often in conjunction with a prescribed exercise program with the aim of improving maximal inter-incisal opening (MIO). This study compared the efficacy (MIO and patient reported outcome results), adverse events, consumer experience and cost of the different types of devices available.
METHODS
Four databases were searched between the years 2001-2021 using the terms 'trismus' and 'device'. Two independent authors assessed each paper for inclusion, then conducted a quality analysis.
RESULTS
Thirty-two studies met the criterion required for inclusion. The majority (n = 27) were in the context of established trismus, where the remaining five used the device preventatively. The trismus device improved MIO in 23 of the rehabilitation programs (pooled mean MIO increased by 9.5 mm in the intervention arm compared to 2.4 mm for controls; p = 0.0001). Improved MIO was not observed in the prevention studies. The Therabite ® was the most common trismus device investigated and with a mean increase in MIO of 10.0 mm and cost of $499AUD. Forces applied by trismus devices were regulated by the perception of pain experienced by the patient, rather than a prescribed force by the treating health professional. Despite this guidance, several adverse events occurred (n = 8), including mandibular and molar fractures. Barriers experienced by consumers included pain, ill-fitting mouthpiece, adverse events, exercise adherence and cost.
CONCLUSION
Trismus devices which use the application of force to the jaw can improve the MIO of patients with established trismus. However, their role is unproven in the setting of trismus prevention during radiotherapy and several significant barriers such as cost, exercise adherence and safety concerns have been demonstrated for the intervention setting.
Topics: Exercise Therapy; Head and Neck Neoplasms; Humans; Pain; Prospective Studies; Quality of Life; Trismus
PubMed: 35104753
DOI: 10.1016/j.oraloncology.2022.105728 -
Journal of Cranio-maxillo-facial... Nov 2019A comprehensive literature search on implant placement protocols after tooth extraction (immediate, early, delayed, or later) was performed up to 2018. The screening... (Meta-Analysis)
Meta-Analysis
Which is the best choice after tooth extraction, immediate implant placement or delayed placement with alveolar ridge preservation? A systematic review and meta-analysis.
A comprehensive literature search on implant placement protocols after tooth extraction (immediate, early, delayed, or later) was performed up to 2018. The screening process selected only randomized clinical trials (RCTs) from PubMed, Embase, Cochrane Library, Web of Science, Scopus, LILACS, and grey literature. A series of pairwise meta-analyses was carried out to evaluate implant performance in each protocol. The primary outcomes were implant survival and esthetic outcome, measured by pink esthetic score (PES), and the secondary outcomes were peri-implant bone resorption and implant complications. The outcomes were at least 1 year after implant surgery. A total of 5056 studies were found, of which 16 were included for qualitative analysis and 9 for quantitative analysis. The meta-analysis showed increased risk of implant failure by 3% in the immediate implant protocol. PES analysis showed no statistical significant difference between immediate or delayed protocols (p = 0.16). However, the subgroup analysis showed that the anterior region presented better results with immediate implants, while the molar region presented better results with delayed implants. The quantitative analysis showed no statistical difference in peri-implant bone resorption between the immediate and delayed implant protocols (p = 0.42). Due to the lack of studies with a low risk of bias, further RCTs are needed for definitive conclusions.
Topics: Alveolar Process; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Randomized Controlled Trials as Topic; Time Factors; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 31522823
DOI: 10.1016/j.jcms.2019.08.004 -
European Journal of Paediatric Dentistry Dec 2023Molar incisor hypomeralisation (MIH) is a dental condition clinically characterised by the presence of morphological and qualitative enamel defects involving the...
AIM
Molar incisor hypomeralisation (MIH) is a dental condition clinically characterised by the presence of morphological and qualitative enamel defects involving the occlusal and/or incisal third of one or more permanent molars or incisors. Its worldwide prevalence ranges between 2.4 and 40%. Several harmful conditions, such as genetic or medical problems during pregnancy, may act together and increase the risk of MIH. The main objective of this systematic review is to assess whether there is a correlation between MIH and dental caries in mixed or permanent dentition.
METHODS
An electronic search was performed on PubMed (Medline), Scopus and Cochrane Library for articles published from August 2022 to April 2023. Cohort, cross-sectional, retrospective and prospective studies were included. In vitro and animal studies, as well as clinical cases and systematic reviews, were excluded. Studies not differentiating between mixed and permanent dentition were excluded. The observed variables were DMFT (Decayed Missed Filled Teeth) score, DMFS (Decayed Missed Filled Surface) and DMF scores related to FPM (First Permanent Molar) and the clinical prevalence of MIH.
CONCLUSION
DMFT, DMFS and DMFT on FPM scores are significantly different between the group of patients with MIH and the control group. The available evidence supports a correlation between MIH lesions and caries. Caries indexes scores increase proportionally to the severity of MIH.
Topics: Animals; Female; Pregnancy; Humans; Child; Cross-Sectional Studies; Dental Caries; Dental Caries Susceptibility; Molar Hypomineralization; Prevalence; Prospective Studies; Retrospective Studies; Molar
PubMed: 38015112
DOI: 10.23804/ejpd.2023.1985 -
Archives of Oral Biology Aug 2023To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic... (Review)
Review
OBJECTIVE
To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic review.
DESIGN
A search was performed in Medline-PubMed, Scopus, Embase and Web of Science databases; manual search and search in gray literature were also performed. Selection of articles was performed independently by two researchers. A third examiner was involved in cases of disagreement. Data extraction was performed using an Excel® spreadsheet and independent analysis was performed for each outcome.
RESULTS
Sixteen studies were included. There was an association between MIH and genetic variants related to amelogenesis, immune response, xenobiotic detoxification and other genes. Moreover, interactions between amelogenesis and immune response genes, and SNPs in the aquaporin gene and vitamin D receptors were associated with MIH. Greater agreement of MIH was found in pairs of monozygotic twins than dizygotic twins. The heritability of MIH was 20 %. Hypomineralised second primary molars was associated with SNPs in the hypoxia-related HIF-1 gene and methylation in genes related to amelogenesis.
CONCLUSION
With very low or low certainty of evidence, an association was observed between MIH and SNPs in genes associated with amelogenesis, immune response, xenobiotic detox and ion transport. Interactions between genes related to amelogenesis and immune response as well as aquaporin genes were associated to MIH. With very low certainty of evidence, hypomineralised second primary molars was associated to a hypoxia-related gene and to methylation in genes related to amelogenesis. Moreover, higher agreement of MIH in pairs of monozygotic twins than dizygotic twins was observed.
Topics: Humans; Dental Enamel Hypoplasia; Molar Hypomineralization; Xenobiotics; Amelogenesis; Molar; Prevalence
PubMed: 37210809
DOI: 10.1016/j.archoralbio.2023.105716 -
Journal of Clinical Periodontology Jan 2021To analyse the evidence pertaining to post-extraction dimensional changes in the alveolar ridge after unassisted socket healing. (Meta-Analysis)
Meta-Analysis Review
AIM
To analyse the evidence pertaining to post-extraction dimensional changes in the alveolar ridge after unassisted socket healing.
MATERIALS AND METHODS
The protocol of this PRISMA-compliant systematic review (SRs) was registered in PROSPERO (CRD42020178857). A literature search to identify studies that fulfilled the eligibility criteria was conducted. Data of interest were extracted. Qualitative and random-effects meta-analyses were performed if at least two studies with comparable features and variables reported the same outcome of interest.
RESULTS
Twenty-eight articles were selected, of which 20 could be utilized for the conduction of quantitative analyses by method of assessment (i.e. clinical vs radiographic measurements) and location (i.e. non-molar vs molar sites). Pooled estimates revealed that mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed clinically in non-molar sites was 2.73 mm (95% CI: 2.36-3.11), 1.71 mm (95% CI: 1.30-2.12) and 1.44 mm (95% CI: 0.78-2.10), respectively. Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in non-molar sites was 2.54 mm (95% CI: 1.97-3.11), 1.65 mm (95% CI: 0.42-2.88) and 0.87 mm (95% CI: 0.36-1.38), respectively. Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in molar sites was 3.61 mm (95% CI: 3.24-3.98), 1.46 mm (95% CI: 0.73-2.20) and 1.20 mm (95% CI: 0.56-1.83), respectively.
CONCLUSION
A variable amount of alveolar bone resorption occurs after unassisted socket healing depending on tooth type.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Humans; Tooth Extraction; Tooth Socket
PubMed: 33067890
DOI: 10.1111/jcpe.13390 -
JDR Clinical and Translational Research Apr 2023Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not support proper treatment. Previous risk estimates were constructed based on the experience in short-duration space missions and isolated environments on Earth. However, previous estimates did not account for potential changes in dental structures due to space travel, even though bone loss is a known problem for long-duration spaceflights. The objective of this study was to systematically analyze the changes in hard tissues of the craniofacial complex during spaceflights.
METHODS
Comprehensive search of Medline, Embase, Scopus, the NASA Technical Report Server, and other sources identified 1,585 potentially relevant studies. After screening, 32 articles that presented quantitative data for skull in humans (6/32) and for calvariae, mandible, and lower incisors in rats (20/32) and mice (6/32) were selected.
RESULTS
Skull bone mineral density showed a significant increase in spacefaring humans. In spacefaring rodents, calvariae bone volume to tissue volume (BV/TV) demonstrated a trend toward increasing that did not reach statistical significance, while in mandibles, there was a significant decrease in BV/TV. Dentin thickness and incisor volume of rodent incisors were not significantly different between spaceflight and ground controls.
DISCUSSION
Our study demonstrates significant knowledge gaps regarding many structures of the craniofacial complex such as the maxilla, molar, premolar, and canine teeth, as well as small sample sizes for the studies of mandible and incisors. Understanding the effects of microgravity on craniofacial structures is important for estimating risks during long-duration spaceflight and for formulating proper protocols to prevent dental emergencies.
KNOWLEDGE TRANSFER STATEMENT
Avoiding dental emergencies in long-duration spaceflights is critical since this environment does not support proper treatment. Prior risk estimates did not account for changes in dental structures due to space travel. We reviewed and synthesized the literature for changes in craniofacial complex associated with spaceflight. The results of our study will help clinicians and scientists to better prepare to mitigate potential oral health issues in space travelers on long-duration missions.
Topics: Humans; Mice; Rats; Animals; Emergencies; Space Flight; Head; Skull; Incisor
PubMed: 35311413
DOI: 10.1177/23800844221084985 -
The Japanese Dental Science Review Dec 2023Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and... (Review)
Review
Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and establish their genotype-phenotype correlation. Forty articles were eligible for 178 patients and 61 mutations (26 in frame and 32 null mutations). mutations predominantly affected molars, mostly the second molar, and the mandibular first premolar was the least affected. More missing teeth were found in the maxilla than the mandible, and with null mutations than in-frame mutations. The number of missing teeth was correlated with the locations of the in-frame mutations with the C-terminus mutations demonstrating the fewest missing teeth. The null mutation location did not influence the number of missing teeth. Null mutations in all locations predominantly affected molars. For the in-frame mutations, a missing second molar was commonly associated with mutations in the highly conserved paired DNA-binding domain, particularly the linking peptide (100% prevalence). In contrast, C-terminus mutations were rarely associated with missing second molars and anterior teeth, but were commonly related to an absent second premolar. These finding indicate that the mutation type and position contribute to different degrees of loss of function that further differentially influences the manifestations of TA. This study provides novel information on the correlation of the genotype-phenotype, aiding in the genetic counseling for TA.
PubMed: 37159578
DOI: 10.1016/j.jdsr.2023.04.001