Patterns of Hypodontia among Third Molars in Contemporary American Adolescents

Abstract

Third molars (M3s) are congenitally absent (hypodontic) more frequently than any other tooth type. Causes of this enhanced variability are poorly understood, but the potential range of absence—from none through four M3s per person—provides the opportunity to examine the permutations of missing M3s within and among ethnic groups. Teenage samples of two overlapping populations (1,100 American whites; 600 American blacks) were studied here, with radiographic confirmation of each tooth’s presence in the jaws. Roughly 15% of these people are missing at least one M3, but only about 2% of this sample is hypodontic for all four molars. The frequency and severity of missing M3s are significantly higher in whites than blacks. Within individuals, correspondence of occurrence is much higher within than between the jaws, but all combinations of M3 hypodontia are positive and significant statistically—implying common underlying developmental influences. While various sorts of data support a genetic influence on the risk of M3 hypodontia, patterns of inheritance suggest a multifactorial rather than a single-gene mode of inheritance. Several researchers have promoted a polygenic threshold model, and the history and application of this model are discussed.