title: Mild hypodontia is associated with smaller tooth dimensions and cusp numbers than in controls.
abstract: OBJECTIVE
  The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of the Complex Adaptive System that is dental development. The aim of this study was to investigate the clinical relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls in a Romanian sample.
  
  
  METHODS
  Digital images of dental casts of the permanent dentition from 28 patients with mild hypodontia and 28 controls were used. Measurements from the vestibular and occlusal surfaces were performed using a 2D image analysis method and cusps, including the Carabelli trait, were counted. Two-way analysis of variance was performed.
  
  
  RESULTS
  The dimensions of the mild hypodontia group had smaller values than the controls, with many measurements being significantly different (significance values varied from p=0.049 to p=0.001). The most affected regions were the upper and lower anterior region in both sexes. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were affected. Females from the hypodontia group had significantly less tricuspidated lower premolars when compared with the control group. Carabelli cusps were present in the hypodontia group less frequently, the difference being highly significant (p=0.0002) in women.
  
  
  CONCLUSIONS
  The hypodontia patients presented with reduced crown dimensions and shape compared with controls. This is the first published study to demonstrate smaller cusp numbers in patients with hypodontia than in controls. The findings are compatible with a model of dental development as a Complex Adaptive System incorporating associations between tooth number, size and shape.
authors.affiliation: Department of Morphology of Teeth and Dental Arches, Faculty of Dentistry, University of Medicine and Pharmacy of Tg-Mures, Gh. Marinescu 38, Tirgu-Mures, Romania. Electronic address: bernadette.kerekes@umftgm.ro.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kerekes-Máthé
authors.affiliation: School of Dentistry, University of Adelaide, Adelaide, South Australia, 5005 Australia. Electronic address: alan.brook@adelaide.edu.au.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Brook
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Tg-Mures, Gh. Marinescu 38, Tirgu-Mures, Romania. Electronic address: marthakriszti@yahoo.com.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Mártha
authors.affiliation: Department of Morphology of Teeth and Dental Arches, Faculty of Dentistry, University of Medicine and Pharmacy of Tg-Mures, Gh. Marinescu 38, Tirgu-Mures, Romania. Electronic address: szekely.melinda@umftgm.ro.
authors.forename: Melinda
authors.initials: M
authors.lastname: Székely
authors.affiliation: School of Dentistry, University of Liverpool, Pembroke Place, Liverpool L3 5PS, United Kingdom. Electronic address: R.N.Smith@liverpool.ac.uk.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000848:Anodontia / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D003765:Models, Dental; D009811:Odontometry; D010781:Photography / Q000295:instrumentation; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012383:Romania / Q000453:epidemiology; D012737:Sex Factors; D019228:Tooth Crown / Q000002:abnormalities*
keywords: Carabelli cusp; Cusp number; Hypodontia; Tooth dimension