Abstract
Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process, resulting in abnormalities in tooth number, structure, and morphology. These anomalies typically manifest during childhood, impairing dental function, maxillofacial development, and facial aesthetics, while also potentially impacting overall physical and mental health. The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention, early diagnosis, and treatment. As they usually emerge early in life, long-term management and multidisciplinary collaboration in dental care are essential. However, there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions, adding to the difficulties in clinical practice. In response to this need, this expert consensus summarizes the classifications, etiology, typical clinical manifestations, and diagnostic criteria of tooth developmental anomalies based on current clinical evidence. It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment, promoting early intervention and standardized care for these anomalies.
Introduction
Tooth development is a highly orchestrated biological process that begins with the formation of the dental lamina and placode, progressing through distinct stages such as morphogenesis, histodifferentiation, and mineralization. Each stage relies on precise spatial and temporal signaling interactions between epithelial and mesenchymal tissues. Disruptions at any point in this process can result in tooth developmental anomalies. , These disruptions may arise from genetic factors, such as mutations in genes critical for tooth development, and/or from environmental influences, including exposure to certain chemicals, infections, trauma, and other external factors. As a result, dental anomalies can present in various forms, including abnormalities in tooth number, size, shape, or structure.
Beyond common infectious diseases, developmental dental anomalies are also significant contributors to the impairment of tooth hard tissues and have a substantial impact on oral health. These anomalies are rooted in congenital disturbances and cause irreversible damage. , Once affected, the compromised hard tissue cannot regenerate, leading to a lifelong impact. They can further negatively affect mastication, articulation, and facial esthetics, thereby reducing quality of life and potentially harming mental health. , Due to the low prevalence of tooth developmental anomalies, dentists often have a limited understanding of these anomalies, making it challenging for them to provide standardized diagnoses, clinical management, and appropriate oral health guidance. Therefore, the diagnosis and treatment of tooth developmental anomalies are critical aspects of oral disease prevention and management.
This consensus primarily focuses on tooth developmental anomalies that occur in isolation, including structural anomalies of enamel and dentin, as well as morphological anomalies such as dens invaginatus (DI) and taurodontism. Based on current clinical evidence, this consensus was developed through the collaborative efforts of a multidisciplinary team of dental experts. It provides a comprehensive analysis of the classifications, etiology, clinical manifestations of these anomalies, and diagnostic criteria or proposed diagnostic guidelines, as well as strategies for prevention and clinical management. The goal is to offer guidance for clinicians in diagnosing and managing these conditions effectively. For tooth anomalies associated with systemic syndromes, this expert consensus offers clinical management recommendations specifically for the accompanying structural or morphological abnormalities but does not address other systemic manifestations.
