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      Analyses of oligodontia phenotypes and genetic etiologies

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          Abstract

          Oligodontia is the congenital absence of six or more teeth and comprises the more severe forms of tooth agenesis. Many genes have been implicated in the etiology of tooth agenesis, which is highly variable in its clinical presentation. The purpose of this study was to identify associations between genetic mutations and clinical features of oligodontia patients. An online systematic search of papers published from January 1992 to June 2021 identified 381 oligodontia cases meeting the eligibility criteria of causative gene mutation, phenotype description, and radiographic records. Additionally, ten families with oligodontia were recruited and their genetic etiologies were determined by whole-exome sequence analyses. We identified a novel mutation in WNT10A (c.99_105dup) and eight previously reported mutations in WNT10A (c.433 G > A; c.682 T > A; c.318 C > G; c.511.C > T; c.321 C > A), EDAR (c.581 C > T), and LRP6 (c.1003 C > T, c.2747 G > T). Collectively, 20 different causative genes were implicated among those 393 cases with oligodontia. For each causative gene, the mean number of missing teeth per case and the frequency of teeth missing at each position were calculated. Genotype–phenotype correlation analysis indicated that molars agenesis is more likely linked to PAX9 mutations, mandibular first premolar agenesis is least associated with PAX9 mutations. Mandibular incisors and maxillary lateral incisor agenesis are most closely linked to EDA mutations.

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          Most cited references63

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          Wnt/β-Catenin/Tcf Signaling Induces the Transcription of Axin2, a Negative Regulator of the Signaling Pathway

          Axin2/Conductin/Axil and its ortholog Axin are negative regulators of the Wnt signaling pathway, which promote the phosphorylation and degradation of β-catenin. While Axin is expressed ubiquitously, Axin2 mRNA was seen in a restricted pattern during mouse embryogenesis and organogenesis. Because many sites of Axin2 expression overlapped with those of several Wnt genes, we tested whether Axin2 was induced by Wnt signaling. Endogenous Axin2 mRNA and protein expression could be rapidly induced by activation of the Wnt pathway, and Axin2 reporter constructs, containing a 5.6-kb DNA fragment including the promoter and first intron, were also induced. This genomic region contains eight Tcf/LEF consensus binding sites, five of which are located within longer, highly conserved noncoding sequences. The mutation or deletion of these Tcf/LEF sites greatly diminished induction by β-catenin, and mutation of the Tcf/LEF site T2 abolished protein binding in an electrophoretic mobility shift assay. These results strongly suggest that Axin2 is a direct target of the Wnt pathway, mediated through Tcf/LEF factors. The 5.6-kb genomic sequence was sufficient to direct the tissue-specific expression of d2EGFP in transgenic embryos, consistent with a role for the Tcf/LEF sites and surrounding conserved sequences in the in vivo expression pattern of Axin2 . Our results suggest that Axin2 participates in a negative feedback loop, which could serve to limit the duration or intensity of a Wnt-initiated signal.
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            A meta-analysis of the prevalence of dental agenesis of permanent teeth.

            To gain more insight into the prevalence of dental agenesis. Data from Caucasian populations in North America, Australia and Europe were included in a meta-analysis. For the prevalence of African American, Chinese and Arab groups only indications could be reported because of a limited number of studies. Agenesis differs by continent and gender: the prevalence for both sexes was higher in Europe (males 4.6%; females 6.3%) and Australia (males 5.5%; females 7.6%) than for North American Caucasians (males 3.2%; females 4.6%). In addition, the prevalence of dental agenesis in females was 1.37 times higher than in males. The mandibular second premolar was the most affected tooth, followed by the maxillary lateral incisor and the maxillary second premolar. The occurrence of dental agenesis was divided into three main groups: common (P2(i) > I2(s) > P2(s)), less common (I1(i) > I2(i) & P1(s) > C(s) & M2(i)) and rare (M2(s) & M1(s) > C(i) > M1(i) & I1(s)). Unilateral occurrence of dental agenesis is more common than bilateral occurrence. However, bilateral agenesis of maxillary lateral incisors is more common than unilateral agenesis. The overall prevalence of agenesis in the maxilla is comparable with that in the mandible, but a marked difference was found between both jaws regarding tooth type. Absence of one or two permanent teeth is found in 83% of the subjects with dental agenesis. A practical application of the results of the meta-analysis is the estimation of dental treatment need. Copyright Blackwell Munksgaard, 2004
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              Mutations in AXIN2 cause familial tooth agenesis and predispose to colorectal cancer.

              Wnt signaling regulates embryonic pattern formation and morphogenesis of most organs. Aberrations of regulation of Wnt signaling may lead to cancer. Here, we have used positional cloning to identify the causative mutation in a Finnish family in which severe permanent tooth agenesis (oligodontia) and colorectal neoplasia segregate with dominant inheritance. Eleven members of the family lacked at least eight permanent teeth, two of whom developed only three permanent teeth. Colorectal cancer or precancerous lesions of variable types were found in eight of the patients with oligodontia. We show that oligodontia and predisposition to cancer are caused by a nonsense mutation, Arg656Stop, in the Wnt-signaling regulator AXIN2. In addition, we identified a de novo frameshift mutation 1994-1995insG in AXIN2 in an unrelated young patient with severe tooth agenesis. Both mutations are expected to activate Wnt signaling. The results provide the first evidence of the importance of Wnt signaling for the development of dentition in humans and suggest that an intricate control of Wnt-signal activity is necessary for normal tooth development, since both inhibition and stimulation of Wnt signaling may lead to tooth agenesis. Our findings introduce a new gene for hereditary colorectal cancer and suggest that tooth agenesis may be an indicator of cancer susceptibility.
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                Author and article information

                Contributors
                yiqunwu@hotmail.com
                jsimmer@umich.edu
                Journal
                Int J Oral Sci
                Int J Oral Sci
                International Journal of Oral Science
                Nature Publishing Group UK (London )
                1674-2818
                2049-3169
                30 September 2021
                30 September 2021
                2021
                : 13
                : 32
                Affiliations
                [1 ]GRID grid.214458.e, ISNI 0000000086837370, Dental Research Laboratory, University of Michigan School of Dentistry, ; Ann Arbor, MI USA
                [2 ]GRID grid.16821.3c, ISNI 0000 0004 0368 8293, Department of Second Dental Center, Shanghai Ninth People’s Hospital, , Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, ; Shanghai, China
                [3 ]GRID grid.16821.3c, ISNI 0000 0004 0368 8293, Department of General Dentistry, Shanghai Ninth People’s Hospital, , Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, ; Shanghai, China
                [4 ]GRID grid.214458.e, ISNI 0000000086837370, Orthodontic and Pediatric Dentistry, University of Michigan School of Dentistry, 1011N. University Ave, ; Ann Arbor, MI USA
                [5 ]GRID grid.477608.a, ISNI 0000 0004 0504 3114, Mott Children’s Health Center 806 Tuuri Place, ; Flint, MI USA
                [6 ]GRID grid.9601.e, ISNI 0000 0001 2166 6619, Department of Pedodontics, Faculty of Dentistry, , Istanbul University, ; Istanbul, Turkey
                [7 ]GRID grid.31501.36, ISNI 0000 0004 0470 5905, Department of Molecular Genetics & Dental Research Institute School of Dentistry, , Seoul National University, ; Seoul, Korea
                [8 ]GRID grid.31501.36, ISNI 0000 0004 0470 5905, Department of Pediatric Dentistry & Dental Research Institute School of Dentistry, , Seoul National University, ; Seoul, Korea
                [9 ]GRID grid.1694.a, Department of Paediatric Dentistry, , Women’s and Children’s Hospital, ; North Adelaide, SA Australia
                [10 ]GRID grid.428608.0, ISNI 0000 0004 0444 4338, Department of Medical Genetics, , Joe DiMaggio Children’s Hospital, ; Hollywood, FL USA
                [11 ]GRID grid.16821.3c, ISNI 0000 0004 0368 8293, Department of Oral Implantology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, , Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, ; Shanghai, China
                Author information
                http://orcid.org/0000-0002-9399-2197
                http://orcid.org/0000-0002-7192-6105
                Article
                135
                10.1038/s41368-021-00135-3
                8484616
                34593752
                c4f245e2-669d-4705-802c-475aa6b8258a
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 April 2021
                : 24 August 2021
                : 25 August 2021
                Funding
                Funded by: FundRef https://doi.org/10.13039/100000072, U.S. Department of Health & Human Services | NIH | National Institute of Dental and Craniofacial Research (NIDCR);
                Award ID: DE015846
                Award Recipient :
                Categories
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                © The Author(s) 2021

                Dentistry
                dental diseases,disease genetics
                Dentistry
                dental diseases, disease genetics

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