Congenitally missing first permanent molars: a case report

Abstract

The congenital absence of teeth is the most commonly knowndevelopmental dental anomaly in humans. It occurs either as anisolated abnormality, or in association with various syndromes andconditions. In the general population the reported incidence ofpermanent tooth agenesis ranges from 1.6% to 9.6% (excluding thethird molars) and 0.5% to 0.9% in the primary dentition. The first permanent molars are considered by some authorities to be themost important teeth in the dentition. Agenesis of the maxillaryfirst permanent molars is a rare finding and when present usuallyoccurs in association with oligodontia. We report a case of a seven-year-old girl who presented with the unusual combination ofmissing maxillary first permanent molars and second premolars.Her medical history was unremarkable. The clinical examinationshowed normal development of the dentition except for the absenceof the maxillary permanent first molars. Radiographic findingsconfirmed the agenesis of the maxillary permanent first molars, aswell as the maxillary right second premolar and the two mandib-ular second premolars. There appeared to be a slight delay in themineralization of the mandibular left second molar tooth germ incomparison to the remaining second molar tooth germs. Earlydiagnosis of patients with hypodontia is valuable because it allowsthe practitioner to formulate a multi-disciplinary treatment planwith both short and long-term management options, therebypossibly reducing the complexity of the later orthodontic andrestorative treatment.