Oligodonti

Oligodonti is a dental developmental disorder defined by the congenital absence of six or more permanent teeth, excluding third molars. It is a form of tooth agenesis; when fewer than six teeth are missing the condition is called hypodontia, and when all teeth are absent it is termed anodontia. Oligodonti can be non-syndromic or syndromic, with the latter occurring as part of a broader condition such as ectodermal dysplasia.

The cause is largely genetic. Non-syndromic oligodonti often follows autosomal dominant or autosomal recessive inheritance and is linked to mutations in genes involved in tooth development, including MSX1, PAX9, AXIN2, and WNT10A. Mutations in EDA or EDAR are associated with syndromic forms that include ectodermal dysplasia features. Environmental factors generally play a smaller role. The condition may present with missing teeth in both anterior and posterior regions and can be associated with delayed eruption and alterations in the development of the alveolar ridges.

Diagnosis is based on clinical examination and radiographic imaging, typically with panoramic radiographs. In suspected syndromic cases, genetic testing may be performed to identify specific gene mutations and guide counseling.

Management requires a multidisciplinary approach, emphasizing function, aesthetics, and oral development. Treatment planning often involves orthodontists, prosthodontists, and, when appropriate, oral surgeons. Options range from interceptive orthodontics and interim prostheses in growing patients to fixed bridges, removable dentures, or dental implants after growth completion, sometimes with ridge augmentation or bone grafting. Regular dental follow-up is important to monitor remaining teeth and oral health.

Prognosis is influenced by the number and location of missing teeth, skeletal development, and access to multidisciplinary care.