Meta-analysis and systematic review of the number of non-syndromic congenitally missing permanent teeth per affected individual and its influencing factors

Abstract

Background and purpose: Dental aplasia (or hypodontia) is a frequent and challenging anomaly and thus of interest to many dental fields. Although the number of missing teeth (NMT) in each person is a major clinical determinant of treatment need, there is no meta-analysis on this subject. Therefore, we aimed to investigate the relevant literature, including epidemiological studies and research on dental/orthodontic patients.

Methods: Among 50 reports, the effects of ethnicities, regions, sample sizes/types, subjects' minimum ages, journals' scientific credit, publication year, and gender composition of samples on the number of missing permanent teeth (except the third molars) per person were statistically analysed (α = 0.05, 0.025, 0.01).

Limitations: The inclusion of small studies and second-hand information might reduce the reliability. Nevertheless, these strategies increased the meta-sample size and favoured the generalisability. Moreover, data weighting was carried out to account for the effect of study sizes/precisions.

Results: The NMT per affected person was 1.675 [95% confidence interval (CI) = 1.621-1.728], 1.987 (95% CI = 1.949-2.024), and 1.893 (95% CI = 1.864-1.923), in randomly selected subjects, dental/orthodontic patients, and both groups combined, respectively. The effects of ethnicities (P > 0.9), continents (P > 0.3), and time (adjusting for the population type, P = 0.7) were not significant. Dental/orthodontic patients exhibited a significantly greater NMT compared to randomly selected subjects (P < 0.012). Larger samples (P = 0.000) and enrolling younger individuals (P = 0.000) might inflate the observed NMT per person.

Conclusions: Time, ethnic backgrounds, and continents seem unlikely influencing factors. Subjects younger than 13 years should be excluded. Larger samples should be investigated by more observers.