Diagnosis & Considerations
Agenesis
Agenesis is the developmental absence of a tooth. Aetiologic factors include genetics (MSX 1 for incisors and premolars, PAX9 for molars, and AXIN2 for lower incisors) (Cobourne 2007, Al-ani et al. 2017), a field theory (Bulter 1939) and other theories, and associated environmental factors such as clefts and dysplasias (Al-ani et al. 2017).
Missing due to environmental factors
Environmental factors can influence agenesis and also teeth to be missing after its development. Though hypodontia is strictly agenesis of teeth (Goodman et al. 1994), early loss of teeth should be treated similarly as malocclusions with dental agenesis.
Clinical Considerations
The overall malocclusion
The smile and shape of the teeth
