What Effect Does Down Syndrome Have on Dental Anomalies and Dental Age in Pediatric Patients?

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İSMAİL CİHANGİR, Esra KIZILCI This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7706517/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 14 You are reading this latest preprint version Abstract BACKGROUND Dental problems in Down Syndrome are among the most easily detected findings. When the studies in the literature were considered, it was seen that not all developmental anomalies were examined. The aim of this study was to examine more anomalies and compare them with the control group and to obtain more information about the dental findings of Down syndrome by including dental age in the study. MATERIALS AND METHODS In our study, panaromic images and, if available, anterior periapical films of 61 Down syndrome and 61 age-matched non-syndromic pediatric patients were analyzed. The dental anomalies of the patients were determined in terms of size, shape, number and texture, and the age of tooth development of both groups was compared using the Nolla method. FINDINGS Dental shape anomalies were numerically higher in patients with Down syndrome except for dens evaginatus, whereas they were statistically significantly higher only in taurodontism. The frequency of hyperdontia and hypodontia, both singly and in combination, was higher in patients with Down syndrome than in healthy patients. Tissue and size anomalies in patients were also observed to be higher in patients with Down syndrome.Although dental age was found to be older in patients with Down syndrome, it was not statistically significant. In the statistical analysis specific to age groups, a statistically significant difference was observed only in the age group of 8 years. CONCLUSIONS It was showed that in our study ,the prevalence of dental anomalies was higher in children with Down syndrome There was no significant relationship between dental age and the presence of the syndrome. Additional studies with an increased sample size are recommended to support our findings. In this way, it is aimed to improve the current service quality by increasing the existing knowledge about pediatric patients with Down syndrome. Dental anomalies Dental age Down Syndrome Figures Figure 1 BACKGROUND First described by Esguirol in 1838, Down Syndrome is a congenital anomaly characterized by delayed mental and physical development. It is most commonly caused by an extra third copy of the 21st chromosome, also known as Trisomy 21. It is reported in one in 600 to 1000 live births and is known to be the most common chromosomal disorder. ( 1 ) Patients have a characterized facial appearance including mid-facial hypoplasia, depressed nasal dorsum, slanted eyes, and open mouth posture. Patients also have systemic problems such as cardiovascular, hematologic and thyroid disorders. In addition to craniofacial anomalies, dental problems are among the most easily identifiable findings of the syndrome. The most commonly observed oral findings include mouth breathing, open bite, macroglossia, hypotonic and scrotal/curved tongue and angular chelitis. ( 2 ) Dental problems include anomalies in number, size, shape and tissue. They can be classified as developmental and acquired according to the timing of occurrence. Deformities that occur in the embryologic stages of teeth are considered developmental, while problems that occur after the development process is completed are called acquired. These anomalies may be observed individually or in association with a syndrome. Developmental dental anomalies can be grouped as size (microdontia/macrodontia), shape (dens invaginatus, talon tubercle, dens evaginatus, gemination, fusion, taurodontism, root dilaceration), number (hyperdontia/hypodontia) and tissue (amelogenesis imperfecta, dentinogenesis imperfecta, dentin dysplasia). ( 3 ) It has been reported that the prevalence of tooth deficiency is 10 times higher in children with Down syndrome compared to healthy children and this rate ranges between 30–60%. Nearly half of Down syndrome patients have microdontia; the teeth show a short conical structure. This leads to the formation of multiple diastema and a lower caries prevalence may be observed.( 4 ) Delay in eruption may be seen in both dentition periods and the timing of eruption may vary. Retinated deciduous teeth are commonly seen (31%). In addition, supernumerary teeth, conical shaped laterals, taurodontism, enamel hypoplasia and calcification are among the developmental anomalies noted.( 5 ) Dental anomalies have aesthetic and functional effects, and problems in the dental arch may affect eruption. Therefore, clinical management of anomalies is of great importance. Innovations in the field of healthcare, specialized education system and increased acceptance in social life have increased the frequency of dental treatment for patients with Down syndrome. Because of its high prevalence, dentists are likely to encounter patients with Down syndrome. ( 6 ) Therefore, knowing the dental anomalies associated with the syndrome will contribute to improving treatment. Considering that patients may have cognitive limitations, taking panoramic radiographs is easier than periapical and tomography ( 7 ). Along with chronic age, height, weight, skeletal, dental and menarche age are used to determine the growth and development status of children. It is accepted that dental age shows less variation compared to skeletal or sex-related growth characteristics. There are various methods used in studies to determine dental age appropriately ( 8 , 9 , 10 ). In the Nolla method, which is one of them and frequently preferred, dental development stages can be determined in a practical way by comparing 10 stages defined graphically with radiographs. There is not enough information in the literature about dental anomalies and dental ages of Turkish children with Down syndrome. In the studies conducted on this subject, not all developmental anomalies have been examined, focusing on certain anomalies.( 11 , 12 , 13 ) The wider range of anomalies examined, comparison with the control group and taking dental age into account distinguish our study from similar studies in the literature. The aim of our study was to compare the dental age and prevalence of dental anomalies in children with Down syndrome with healthy children using panoramic radiographs and to obtain more information on the subject. MATERIALS AND METHODS Ethics committee approval for the study was obtained from Erciyes University Faculty of Medicine Clinical Research Ethics Committee. Since it was a retrospective study, it was not deemed necessary to obtain an informed consent form. This study was designed as a retrospective review of patient radiographs. It is not a clinical trial, so clinical trial registration was not required. The clinical record does not include a trial registration number or registration data. In the power analysis of our study, the alpha significance level was determined as 0.05 at 95% power, the sample size was determined as 50 and calculated with the G*Power Version 3.1.9.2 program, assuming that a moderate effect size (effect size = 0.8) was accepted as a difference in the mean of the parameters. Our study was carried out by examining the panoramic images of 61 Down syndrome pediatric patients between the ages of 5–14 years who applied to Erciyes University Faculty of Dentistry, Department of Pedodontics between 2009 and 2024. A control group was formed by selecting the same number of non-syndromic pediatric patients with similar age group. Panoramic films were examined by a research assistant (I.C.) with 4 years of clinical experience. The control of the analyzed films was performed by a faculty member with 14 years of clinical experience. Cases with different decisions were re-evaluated and common conclusions were reached. Inclusion-Exclusion Criteria; Patients with systemic diseases were excluded from the study because they may have an effect on dental anomalies. Patients who underwent only intraoral examination and could not obtain a panoramic film were not included in the study. Patients with adequate digital panoramic film quality (OPG X-ray machine) (71kv, 16ma, 13.4s; Instrumentarium op200D, Kavo Kerr, Germany) were included in the study and the others (8 radiographs) were excluded. Considering that panoramic radiographs would not provide sufficient quality in the anterior region, periapical radiographs of the patients, if available, were also included in the study. Regardless of the dentition period of the patients, the identified dental anomalies were recorded in terms of size (microdontia, macrodontia) shape (dens invaginatus, talon tubercle, dens evaginatus, gemination, fusion, taurodontism, root dilaceration), number (hyperdontia/hypodontia) and tissue (amelogenesis imperfecta, dentinogenesis imperfecta, dentin dysplasia). The distribution according to tooth type, unilateral or bilateral and presence in the upper/lower jaw were analyzed. In the panoramic films examined, status anomalies (heteropia, ectopia, transposition) were not included in the material method of the study since they were not observed in any patient in either group. The age of tooth development of both groups was compared by averaging the six left mandibular teeth using the Nolla method (Fig. 1). With the method described by Nolla in his study, radiographic images are scored according to the stage in Fig. 1. If the determined developmental status is between two stages, + 0.5 value is added to the score. In cases closer to the lower stage, a score of + 0.2 was added; in cases closer to the upper stage, a score of + 0.7 was added. ( 9 ) SPSS (Statistical Package for the Social Sciences) 23.0 package program was used for statistical analysis of the data. Categorical measurements were summarized as number and percentage, and continuous measurements were summarized as mean and standard deviation (median and minimum-maximum where necessary). Chi-square and Fisher exact tests were used for comparisons of categorical expressions. Shapiro-Wilk test was used to determine whether the parameters in the study were normally distributed. Mann Whitney U test was used for parameters that did not show normal distribution. Statistical significance level was set at 0.05 and 0.001 for all tests. RESULTS Sixty-one patients with Down syndrome (Group 1) and 61 healthy pediatric patients (Group 2) with adequate image quality as a result of the digital panoramic films of the patients admitted to our clinic were included in our study. The ages of the patients ranged between 5–14 years (Group 1 = 9.5 ± 2.3; Group 2 = 9.5 ± 2.4). The gender ratios of the patients were 49.2% girls (n = 31) and 50.8% boys (n = 30) in Group 1 and 47.5% girls (n = 29) and 52.5% boys (n = 32) in Group 2. The rate of shape anomalies in the teeth of the patients was 63.9% in Group 1 and 42.6% in Group 2. The presence of shape anomalies was numerically higher in Group 1 except for dens evaginatus. In taurodontism, this rate was statistically significantly higher in Group 1. (p < 0.05) (Details of the anomalies are shown in Table 1 ). Table 1 Shape anomalies evaluated in patients and their incidence rates Down (n = 61) Healthy (n = 61) Total (n = 122) p n(%) n(%) n(%) Gender Female 30 (49,2) 29 (47,5) 59 (48,4) 0,856 c Male 31 (50,8) 32 (52,5) 63 (51,6) Dens İnv No 56 (91,8) 57 (93,4) 113 (92,6) 0,729 c Yes 5 ( 8 , 2 ) 4 ( 6 , 6 ) 9 ( 7 , 4 ) Dens Eva No 57 (93,4) 53 (86,9) 110 (90,2) 0,224 c Yes 4 ( 6 , 6 ) 8 ( 13 , 1 ) 12 ( 9 , 8 ) Fusion No 59 (96,7) 61 (100) 120 (98,4) 0,154 c Yes 2 ( 3 , 3 ) - 2 ( 1 , 6 ) Taurodontism No 39 (63,9) 49 (80,3) 88 (72,1) 0,043* ,c Yes 22 (36,1) 12 ( 19 , 7 ) 34 (27,9) Dilaceration No 49 (80,3) 55 (90,2) 104 (85,2) 0,126 c Yes 12 ( 19 , 7 ) 6 ( 9 , 8 ) 18 ( 14 , 8 ) Hyperdontia No 52 (85,2) 60 (98,4) 112 (91,8) 0,008* ,c Yes 9 ( 14 , 8 ) 1 ( 1 , 6 ) 10 ( 8 , 2 ) Hypodontia No 35 (57,4) 58 (95,1) 93 (76,2) < 0,001** ,c Yes 26 (42,6) 3 ( 4 , 9 ) 29 ( 23 , 8 ) Hyperdontia&Hypodontia No 28(45,9) 57(93,4) 85 (69,7) < 0,001** ,c Singular 31 (50,7) 4 ( 6 , 6 ) 35 (28,7) Plural 2 ( 3 , 3 ) - 2 ( 1 , 6 ) Tissue No 56(91,8) 61(100) 117 (95,9) 0,022* ,c Yes 5 ( 8 , 2 ) - 5 ( 4 , 1 ) Amelogenesis No 60(98,4) 61(100) 121 (99,2) 0,315 c Yes 1 ( 1 , 6 ) - 1 (0,8) Dentinogenesis No 58(95,1) 61(100) 119 (97,5) 0,079 c Yes 3 ( 4 , 9 ) - 3 ( 2 , 5 ) Dentin Dysplasia No 60(98,4) 61(100) 121 (99,2) 0,315 c Yes 1 ( 1 , 6 ) - 1 (0,8) Microdontia Yes 36 (59,0) 7 ( 11 , 5 ) 43 (35,2) < 0,001** ,c No 26 (41,0) 53 (88,5) 79 (64,8) Macrodontia No 28(45,9) 57(93,4) 85 (69,7) < 0,001** ,c Yes 33 (54,1) 4 ( 6 , 6 ) 37 (30,3) Avarage ± ss Med (Min-Maks) Avarage ± ss Med (Min-Maks) Avarage ± ss Med (Min-Maks) Age 9,5 ± 2,3 9 ( 4 – 14 ) 9,5 ± 2,4 9 ( 4 – 14 ) 9,5 ± 2,3 9 ( 4 – 14 ) 0,807 b Nolla age 8,3 ± 1,4 8,6 ( 3 , 5 – 10 ) 8,5 ± 1,2 8,7 ( 4 , 2 – 10 ) 8,4 ± 1,3 8,6 ( 3 , 5 – 10 ) 0,605 b The presence of hyperdontia and hypodontia was found to be more common in patients with Down syndrome than in healthy patients.(p < 0.05) The frequency of hyperdontia and hypodontia together was also found to be higher in patients with Down syndrome, as in the case of single occurrence.(p < 0.001) The presence of tissue anamolies (dentinogenesis/amelogenesis imperfecta, dentin dysplasia), macrodontia and microdontia were higher in group 1 (p < 0.001) The distribution of patients according to chronologic age and Nolla dental age is given in Table 2 . Although Nolla age was found to be older than biological age in Group 1, there was no statistically significant difference between the presence of the syndrome and dental age. (p = 0.605) In the statistical analysis performed specific to age groups, analysis could not be performed in the 5-year age group due to insufficient number of patients; in the compared groups, a statistically significant difference was found between the groups at 8 years of age (p = 0.019). Table 2 Distribution of patients according to chronological age and Nolla tooth age Ages of all patients (n = 122) Nolla age Avarage ± ss Med (Min-Maks) 5 5,9 ± 0,2 5,95 (5,83 − 6,08) 6 6,2 ± 0,5 6,07 (5,72 − 6,75) 7 7,0 ± 0,7 6,88 (6,05–8,21) 8 7,8 ± 0,7 7,91 (6,01–9,18) 9 8,2 ± 0,8 8,33 (6,52 − 9,3) 10 8,9 ± 0,5 8,93 (7,71 − 9,68) 11 9,2 ± 0,3 9,31 (8,63 − 9,51) 12 9,6 ± 0,4 9,69 ( 9 – 10 ) 13 9,9 ± 0,2 10 ( 9 , 6 – 10 ) 14 9,9 ± 0,3 10 (9,38 − 10) Patients with Down Syndrome (n = 61) 5 5,8 ± 0,0 5,83 (5,83 − 5,83) 6 5,8 ± 0,1 5,79 (5,72 − 5,86) 7 6,9 ± 0,7 6,87 (6,05–7,93) 8 7,4 ± 0,8 7,48 (6,01–8,26) 9 8,1 ± 0,9 8,12 (6,52 − 9,08) 10 9,0 ± 0,6 9,26 (7,71 − 9,68) 11 9,1 ± 0,3 9,18 (8,63 − 9,51) 12 9,7 ± 0,5 9,8 ( 9 – 10 ) 13 9,8 ± 0,2 9,76 ( 9 , 6 – 10 ) 14 9,8 ± 0,3 10 (9,38 − 10) Healthy (n = 61) 5 6,0 ± 0,0 4,1 ( 6 , 1 – 6 , 1 ) 6 6,5 ± 0,3 6,5 ( 6 , 3 – 6 , 8 ) 7 7,1 ± 0,7 7,0 ( 6 , 1 – 8 , 2 ) 8 8,2 ± 0,5 8,0 ( 7 , 7 – 9 , 2 ) 9 8,4 ± 0,8 8,4 ( 7 , 1 – 9 , 3 ) 10 8,8 ± 0,4 8,9 ( 8 , 2 – 9 , 5 ) 11 9,2 ± 0,2 9,3 (9,0–9,3) 12 9,6 ± 0,4 9,6 ( 9 , 1 – 10 ) 13 9,9 ± 0,1 10 ( 9 , 8 – 10 ) 14 9,9 ± 0,2 10 ( 9 , 5 – 10 ) DISCUSSION The aim of this study was to determine the prevalence of dental anomalies and Nolla tooth age of children with Down syndrome and to compare them with healthy children. It is aimed to improve the current service quality by increasing the existing knowledge about pediatric patients with Down syndrome. Therefore, the presence and prevalence of dental anomalies are of great importance. Since panoramic radiography was preferred as the methodology, anomalies that could be determined by visual examination such as molar-incisor hypomineralization, turner hypoplasia and fluorosis were not included, and anomalies that could be determined by radiography were examined. In the literature, there are several studies reporting the validity of the Nolla method for tooth age determination in the Turkish population. ( 8 , 14 ) In addition, it has various advantages such as being equally reliable with other methods, including an additional crown mineralization step compared to the Demirjian method, being practical, and not requiring any other equipment and hardware other than panoramic radiography to be taken from the patient. ( 8 , 14 ) It is reported in the literature that panoramic radiographs are more effective than intraoral radiographs as equipment for tooth age determination. ( 15 ) For the reasons mentioned above, the Nolla method was preferred in the present study by using panoramic radiographs to determine tooth age. However, in the present study, all teeth in both jaw quadrants were included as suggested by Nolla, unlike the method of Moraes et al. ( 2 ) which examined 4 teeth. In addition, it has been reported in the literature that the method provides a high agreement rate of 90% between the examiners, which increases the accuracy of the results ( 9 ). Yılmaz et al. and Almaz and ally. reported the prevalence of hypodontia (5.65%-0.52%), root dilaceration (3.62%-0.02%) and taurodontism (0.86%-0.02%) in a healthy Turkish pediatric patient population. It is seen that the reported prevalence values are lower than the values determined in group 2 (4.9%, 9.8% and 19.7%, respectively). We think that the low prevalence value may be due to the limited sample size in the study compared to studies in which only healthy patient populations were evaluated. ( 16 , 17 ) Among the dental anomalies reported, only the prevalence of hypodontia and the highest rates of hypodontia and root dilaceration are similar to the findings of our study. In studies conducted in children with Down syndrome, the anomalies with the highest prevalence are hypodontia and taurodontism. Mestrovic et al. (38.6%) ( 13 ), Acerbi et al. (60%) ( 6 ), Moraes et al. (53.05%) ( 2 ), Sekerci et al. (29%) ( 18 ) and Bamba et al. (65%) ( 19 ) reported the presence of hypodontia most frequently in children with Down syndrome in their study, Bell et al. (36.4%) ( 11 ), Alpöz and Eronat (66%) ( 12 ) and et al, Moraes et al. (85,71) ( 2 ) reported taurodontism as one of the most common anomalies observed in children with Down syndrome in their study results similar to this study. Cuoghi et al. ( 20 ) reported microdontia as the most common anomaly together with hypodontia (16%) in their study with a prevalence of 16%. Sekerci et al. showed that microdontia was the most commonly observed anomaly after hypodontia and taurodontism. ( 18 ) In the present study, the most commonly observed anomalies in children with Down syndrome were hypodontia, taurodontism and microdontia. The present findings are in parallel with the studies in the literature. In their study, Cuoghi et al. found that the prevalence of dental anomalies in individuals with Down syndrome was higher than in the normal population. ( 18 ) This was also reported in similar studies in the literature. ( 2 , 7 , 13 ) Sekerci et al. reported that the prevalence of dental anomalies in individuals with Down syndrome was 5 times higher. ( 18 ) In their study with the Turkish pediatric population, the rate of taurodontism was 81%, while Alpöz et al. ( 12 ) found 66%. In the present study, this rate was determined as 36% due to the use of different sample sizes in different regions of Turkiye. However, dental anomalies were observed to be higher in the DS group compared to the healthy children group in accordance with the literature. In addition, by forming a control group in the present study; DS group and healthy children could be compared in the same population by providing standardization. We think that this method provides more objective results compared to the studies mentioned above. In the present study, no statistically significant relationship was found between the presence of dental anomaly and gender. This finding is highly similar to similar studies in the literature. ( 19 , 20 ) In the literature, there are few studies examining dental age in individuals with Down syndrome. ( 21 ) In the present study, dental age was found to be lower than chronic age in both groups, regardless of gender, but not statistically significant. These findings support the results of Moreas et al. ( 22 ) In a previous study, it was reported that although dental ages within normal limits comparable to chronic age were observed in the majority of individuals with DS, both early and delayed ages were present. ( 23 ) Our results confirmed these findings using a different method. In our sample with an age group of 5–14 years, dental age was determined within normal limits, although early age was observed in the 5-year age group and delayed age in the other groups. Limitations The study has several limitations. Although anomalies that can be detected by radiography are examined when evaluating dental tissue anomalies, supporting panoramic radiographs with clinical observations will reveal more precise results. It is seen that panoramic radiographs are used in various studies for age determination with the Nolla method. ( 21 , 22 ) However, it is reported in the literature that supporting panoramic radiographs with intraoral and lateral skull radiographs may provide more accurate readings. ( 24 , 25 ) Intraoral films were also utilized in the study, especially when evaluating the anterior region. However, since cephalometric films are not preferred for routine examination and extra films were not requested from the patients in this study, this evaluation could not be performed. CONCLUSION In our study, the prevalence of dental anomalies was higher in children with Down syndrome. In both groups, taurodontism and hypodontia were the most common anomalies. In addition, taurodontism and hypodontia were statistically significant in the comparison of the two groups. There was no relationship between gender and the presence of anomalies and dental age. Although Nolla tooth age was found to be lower than chronic age in both groups; it was found to be higher in some age groups. There was no statistically significant finding between Nolla tooth age and the presence of syndrome. Additional studies with increased sample size are recommended to support our findings. Declarations Authors' contributions Funding: No author has a financial or proprietary interest in any material or method mentioned. Conflicts of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Ethics approval and consent to participate: The retrospective study was approved by the Authors University’s Non-Invasive Clinical Practices Ethics Committee. (2022/668) This study was designed as a retrospective review of patient radiographs. It is not a clinical trial, so clinical trial registration was not required. The clinical record does not include a trial registration number or registration data. Consent for publication: No, the results/data/figures in this manuscript have not been published elsewhere, nor are they under consideration (from you or one of your Contributing Authors) by another publisher. Availability of data and materials: All of the material is owned by the authors and/or no permissions are required. Code availability: Not applicable Authors' contributions: Study conception and design: İ.C, E.K ; acquisition of data: İ.C; analysis and interpretation of data: İ.C, E.K; drafting of manuscript: İ.C, E.K,; critical revision: E.K References -Pueschel SM. A historicalviewpoint: Downsyndromegrowingandlearning. Pueschel SM, editor. Canning, Murphy, Zaumer, AndrewsandMcMeel, Inc. Kansas City: DownSyndrome; 1981. P.37 – 9. -De Moraes ME, De Moraes LC, Dotto GN, Dotto PP, dosSantos LR. Dental anomalies in patientswithDownsyndrome. BrazDent J. 2007;18(4):346–50. -Cohen MM, Winer RA. Dentalandfacialcharacteristics in Down’ssyndrome (Mongolism). 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1","display":"","copyAsset":false,"role":"figure","size":509299,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"EkranResmi2025081419.38.50.png","url":"https://assets-eu.researchsquare.com/files/rs-7706517/v1/548ecb876021a3ad2419f640.png"},{"id":98445053,"identity":"10bf8002-cc76-492a-8764-26c60aba69c0","added_by":"auto","created_at":"2025-12-17 17:18:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1349300,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7706517/v1/e6a1ac52-d18f-4c21-b5b6-be1667805405.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eWhat Effect Does Down Syndrome Have on Dental Anomalies and Dental Age in Pediatric Patients?\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eFirst described by Esguirol in 1838, Down Syndrome is a congenital anomaly characterized by delayed mental and physical development. It is most commonly caused by an extra third copy of the 21st chromosome, also known as Trisomy 21. It is reported in one in 600 to 1000 live births and is known to be the most common chromosomal disorder. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003ePatients have a characterized facial appearance including mid-facial hypoplasia, depressed nasal dorsum, slanted eyes, and open mouth posture. Patients also have systemic problems such as cardiovascular, hematologic and thyroid disorders. In addition to craniofacial anomalies, dental problems are among the most easily identifiable findings of the syndrome. The most commonly observed oral findings include mouth breathing, open bite, macroglossia, hypotonic and scrotal/curved tongue and angular chelitis. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Dental problems include anomalies in number, size, shape and tissue. They can be classified as developmental and acquired according to the timing of occurrence. Deformities that occur in the embryologic stages of teeth are considered developmental, while problems that occur after the development process is completed are called acquired. These anomalies may be observed individually or in association with a syndrome.\u003c/p\u003e\u003cp\u003eDevelopmental dental anomalies can be grouped as size (microdontia/macrodontia), shape (dens invaginatus, talon tubercle, dens evaginatus, gemination, fusion, taurodontism, root dilaceration), number (hyperdontia/hypodontia) and tissue (amelogenesis imperfecta, dentinogenesis imperfecta, dentin dysplasia). (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eIt has been reported that the prevalence of tooth deficiency is 10 times higher in children with Down syndrome compared to healthy children and this rate ranges between 30\u0026ndash;60%. Nearly half of Down syndrome patients have microdontia; the teeth show a short conical structure. This leads to the formation of multiple diastema and a lower caries prevalence may be observed.(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) Delay in eruption may be seen in both dentition periods and the timing of eruption may vary. Retinated deciduous teeth are commonly seen (31%). In addition, supernumerary teeth, conical shaped laterals, taurodontism, enamel hypoplasia and calcification are among the developmental anomalies noted.(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eDental anomalies have aesthetic and functional effects, and problems in the dental arch may affect eruption. Therefore, clinical management of anomalies is of great importance. Innovations in the field of healthcare, specialized education system and increased acceptance in social life have increased the frequency of dental treatment for patients with Down syndrome. Because of its high prevalence, dentists are likely to encounter patients with Down syndrome. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eTherefore, knowing the dental anomalies associated with the syndrome will contribute to improving treatment. Considering that patients may have cognitive limitations, taking panoramic radiographs is easier than periapical and tomography (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAlong with chronic age, height, weight, skeletal, dental and menarche age are used to determine the growth and development status of children. It is accepted that dental age shows less variation compared to skeletal or sex-related growth characteristics. There are various methods used in studies to determine dental age appropriately (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In the Nolla method, which is one of them and frequently preferred, dental development stages can be determined in a practical way by comparing 10 stages defined graphically with radiographs.\u003c/p\u003e\u003cp\u003eThere is not enough information in the literature about dental anomalies and dental ages of Turkish children with Down syndrome. In the studies conducted on this subject, not all developmental anomalies have been examined, focusing on certain anomalies.(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) The wider range of anomalies examined, comparison with the control group and taking dental age into account distinguish our study from similar studies in the literature. The aim of our study was to compare the dental age and prevalence of dental anomalies in children with Down syndrome with healthy children using panoramic radiographs and to obtain more information on the subject.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e Ethics committee approval for the study was obtained from Erciyes University Faculty of Medicine Clinical Research Ethics Committee. Since it was a retrospective study, it was not deemed necessary to obtain an informed consent form. This study was designed as a retrospective review of patient radiographs. It is not a clinical trial, so clinical trial registration was not required. The clinical record does not include a trial registration number or registration data.\u003c/p\u003e\u003cp\u003eIn the power analysis of our study, the alpha significance level was determined as 0.05 at 95% power, the sample size was determined as 50 and calculated with the G*Power Version 3.1.9.2 program, assuming that a moderate effect size (effect size\u0026thinsp;=\u0026thinsp;0.8) was accepted as a difference in the mean of the parameters.\u003c/p\u003e\u003cp\u003eOur study was carried out by examining the panoramic images of 61 Down syndrome pediatric patients between the ages of 5\u0026ndash;14 years who applied to Erciyes University Faculty of Dentistry, Department of Pedodontics between 2009 and 2024. A control group was formed by selecting the same number of non-syndromic pediatric patients with similar age group. Panoramic films were examined by a research assistant (I.C.) with 4 years of clinical experience. The control of the analyzed films was performed by a faculty member with 14 years of clinical experience. Cases with different decisions were re-evaluated and common conclusions were reached.\u003c/p\u003e\u003cp\u003e\u003cb\u003eInclusion-Exclusion Criteria;\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePatients with systemic diseases were excluded from the study because they may have an effect on dental anomalies.\u003c/p\u003e\u003cp\u003ePatients who underwent only intraoral examination and could not obtain a panoramic film were not included in the study.\u003c/p\u003e\u003cp\u003ePatients with adequate digital panoramic film quality (OPG X-ray machine) (71kv, 16ma, 13.4s; Instrumentarium op200D, Kavo Kerr, Germany) were included in the study and the others (8 radiographs) were excluded.\u003c/p\u003e\u003cp\u003eConsidering that panoramic radiographs would not provide sufficient quality in the anterior region, periapical radiographs of the patients, if available, were also included in the study.\u003c/p\u003e\u003cp\u003eRegardless of the dentition period of the patients, the identified dental anomalies were recorded in terms of size (microdontia, macrodontia) shape (dens invaginatus, talon tubercle, dens evaginatus, gemination, fusion, taurodontism, root dilaceration), number (hyperdontia/hypodontia) and tissue (amelogenesis imperfecta, dentinogenesis imperfecta, dentin dysplasia). The distribution according to tooth type, unilateral or bilateral and presence in the upper/lower jaw were analyzed. In the panoramic films examined, status anomalies (heteropia, ectopia, transposition) were not included in the material method of the study since they were not observed in any patient in either group.\u003c/p\u003e\u003cp\u003eThe age of tooth development of both groups was compared by averaging the six left mandibular teeth using the Nolla method (Fig.\u0026nbsp;1). With the method described by Nolla in his study, radiographic images are scored according to the stage in Fig.\u0026nbsp;1. If the determined developmental status is between two stages, +\u0026thinsp;0.5 value is added to the score. In cases closer to the lower stage, a score of +\u0026thinsp;0.2 was added; in cases closer to the upper stage, a score of +\u0026thinsp;0.7 was added. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eSPSS (Statistical Package for the Social Sciences) 23.0 package program was used for statistical analysis of the data. Categorical measurements were summarized as number and percentage, and continuous measurements were summarized as mean and standard deviation (median and minimum-maximum where necessary). Chi-square and Fisher exact tests were used for comparisons of categorical expressions. Shapiro-Wilk test was used to determine whether the parameters in the study were normally distributed. Mann Whitney U test was used for parameters that did not show normal distribution. Statistical significance level was set at 0.05 and 0.001 for all tests.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eSixty-one patients with Down syndrome (Group 1) and 61 healthy pediatric patients (Group 2) with adequate image quality as a result of the digital panoramic films of the patients admitted to our clinic were included in our study. The ages of the patients ranged between 5\u0026ndash;14 years (Group 1\u0026thinsp;=\u0026thinsp;9.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3; Group 2\u0026thinsp;=\u0026thinsp;9.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4). The gender ratios of the patients were 49.2% girls (n\u0026thinsp;=\u0026thinsp;31) and 50.8% boys (n\u0026thinsp;=\u0026thinsp;30) in Group 1 and 47.5% girls (n\u0026thinsp;=\u0026thinsp;29) and 52.5% boys (n\u0026thinsp;=\u0026thinsp;32) in Group 2. The rate of shape anomalies in the teeth of the patients was 63.9% in Group 1 and 42.6% in Group 2. The presence of shape anomalies was numerically higher in Group 1 except for dens evaginatus. In taurodontism, this rate was statistically significantly higher in Group 1. (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Details of the anomalies are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eShape anomalies evaluated in patients and their incidence rates\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDown\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthy\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003en(%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" 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colname=\"c4\"\u003e\u003cp\u003e59 (48,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,856\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31 (50,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (52,5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e63 (51,6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDens İnv\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56 (91,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57 (93,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e113 (92,6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,729\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDens Eva\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57 (93,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53 (86,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e110 (90,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,224\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (96,7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e120 (98,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,154\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTaurodontism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (63,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49 (80,3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e88 (72,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0,043*\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (36,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34 (27,9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDilaceration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49 (80,3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55 (90,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e104 (85,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,126\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18 (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52 (85,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60 (98,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e112 (91,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0,008*\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35 (57,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58 (95,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e93 (76,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (42,6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia\u0026amp;Hypodontia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28(45,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57(93,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85 (69,7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingular\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31 (50,7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35 (28,7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTissue\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56(91,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61(100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e117 (95,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0,022*\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmelogenesis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60(98,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61(100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e121 (99,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,315\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0,8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDentinogenesis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58(95,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61(100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e119 (97,5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,079\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDentin Dysplasia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60(98,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61(100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e121 (99,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,315\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0,8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMicrodontia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36 (59,0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43 (35,2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (41,0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53 (88,5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e79 (64,8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMacrodontia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28(45,9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e57(93,4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85 (69,7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003csup\u003e,c\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33 (54,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e37 (30,3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAvarage\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMed (Min-Maks)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eAvarage\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMed (Min-Maks)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eAvarage\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMed (Min-Maks)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9,5\u0026thinsp;\u0026plusmn;\u0026thinsp;2,3\u003c/p\u003e\u003cp\u003e9 (\u003cspan additionalcitationids=\"CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,5\u0026thinsp;\u0026plusmn;\u0026thinsp;2,4\u003c/p\u003e\u003cp\u003e9 (\u003cspan additionalcitationids=\"CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9,5\u0026thinsp;\u0026plusmn;\u0026thinsp;2,3\u003c/p\u003e\u003cp\u003e9 (\u003cspan additionalcitationids=\"CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0,807\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNolla age\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8,3\u0026thinsp;\u0026plusmn;\u0026thinsp;1,4\u003c/p\u003e\u003cp\u003e8,6 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,5\u0026thinsp;\u0026plusmn;\u0026thinsp;1,2\u003c/p\u003e\u003cp\u003e8,7 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6 CR7 CR8 CR9\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8,4\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003cp\u003e8,6 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0,605 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe presence of hyperdontia and hypodontia was found to be more common in patients with Down syndrome than in healthy patients.(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) The frequency of hyperdontia and hypodontia together was also found to be higher in patients with Down syndrome, as in the case of single occurrence.(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003cp\u003eThe presence of tissue anamolies (dentinogenesis/amelogenesis imperfecta, dentin dysplasia), macrodontia and microdontia were higher in group 1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003cp\u003eThe distribution of patients according to chronologic age and Nolla dental age is given in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Although Nolla age was found to be older than biological age in Group 1, there was no statistically significant difference between the presence of the syndrome and dental age. (p\u0026thinsp;=\u0026thinsp;0.605) In the statistical analysis performed specific to age groups, analysis could not be performed in the 5-year age group due to insufficient number of patients; in the compared groups, a statistically significant difference was found between the groups at 8 years of age (p\u0026thinsp;=\u0026thinsp;0.019).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of patients according to chronological age and Nolla tooth age\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAges of all patients (n\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNolla age\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAvarage\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eMed (Min-Maks)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5,95 (5,83\u0026thinsp;\u0026minus;\u0026thinsp;6,08)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6,07 (5,72\u0026thinsp;\u0026minus;\u0026thinsp;6,75)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7,0\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6,88 (6,05\u0026ndash;8,21)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7,91 (6,01\u0026ndash;9,18)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,33 (6,52\u0026thinsp;\u0026minus;\u0026thinsp;9,3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,93 (7,71\u0026thinsp;\u0026minus;\u0026thinsp;9,68)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,31 (8,63\u0026thinsp;\u0026minus;\u0026thinsp;9,51)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,6\u0026thinsp;\u0026plusmn;\u0026thinsp;0,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,69 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (9,38\u0026thinsp;\u0026minus;\u0026thinsp;10)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatients with Down Syndrome (n\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5,83 (5,83\u0026thinsp;\u0026minus;\u0026thinsp;5,83)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5,79 (5,72\u0026thinsp;\u0026minus;\u0026thinsp;5,86)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6,87 (6,05\u0026ndash;7,93)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7,4\u0026thinsp;\u0026plusmn;\u0026thinsp;0,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7,48 (6,01\u0026ndash;8,26)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,12 (6,52\u0026thinsp;\u0026minus;\u0026thinsp;9,08)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,0\u0026thinsp;\u0026plusmn;\u0026thinsp;0,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,26 (7,71\u0026thinsp;\u0026minus;\u0026thinsp;9,68)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,18 (8,63\u0026thinsp;\u0026minus;\u0026thinsp;9,51)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,7\u0026thinsp;\u0026plusmn;\u0026thinsp;0,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,8 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,76 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (9,38\u0026thinsp;\u0026minus;\u0026thinsp;10)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealthy (n\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6,0\u0026thinsp;\u0026plusmn;\u0026thinsp;0,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4,1 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6,5\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6,5 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7,0 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,0 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,4\u0026thinsp;\u0026plusmn;\u0026thinsp;0,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,4 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7 CR8\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8,9 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6 CR7 CR8\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,3 (9,0\u0026ndash;9,3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,6\u0026thinsp;\u0026plusmn;\u0026thinsp;0,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9,6 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7 CR8 CR9\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe aim of this study was to determine the prevalence of dental anomalies and Nolla tooth age of children with Down syndrome and to compare them with healthy children. It is aimed to improve the current service quality by increasing the existing knowledge about pediatric patients with Down syndrome. Therefore, the presence and prevalence of dental anomalies are of great importance. Since panoramic radiography was preferred as the methodology, anomalies that could be determined by visual examination such as molar-incisor hypomineralization, turner hypoplasia and fluorosis were not included, and anomalies that could be determined by radiography were examined.\u003c/p\u003e\u003cp\u003eIn the literature, there are several studies reporting the validity of the Nolla method for tooth age determination in the Turkish population. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) In addition, it has various advantages such as being equally reliable with other methods, including an additional crown mineralization step compared to the Demirjian method, being practical, and not requiring any other equipment and hardware other than panoramic radiography to be taken from the patient. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eIt is reported in the literature that panoramic radiographs are more effective than intraoral radiographs as equipment for tooth age determination. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) For the reasons mentioned above, the Nolla method was preferred in the present study by using panoramic radiographs to determine tooth age. However, in the present study, all teeth in both jaw quadrants were included as suggested by Nolla, unlike the method of Moraes et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) which examined 4 teeth. In addition, it has been reported in the literature that the method provides a high agreement rate of 90% between the examiners, which increases the accuracy of the results (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eYılmaz et al. and Almaz and ally. reported the prevalence of hypodontia (5.65%-0.52%), root dilaceration (3.62%-0.02%) and taurodontism (0.86%-0.02%) in a healthy Turkish pediatric patient population. It is seen that the reported prevalence values are lower than the values determined in group 2 (4.9%, 9.8% and 19.7%, respectively). We think that the low prevalence value may be due to the limited sample size in the study compared to studies in which only healthy patient populations were evaluated. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) Among the dental anomalies reported, only the prevalence of hypodontia and the highest rates of hypodontia and root dilaceration are similar to the findings of our study.\u003c/p\u003e\u003cp\u003eIn studies conducted in children with Down syndrome, the anomalies with the highest prevalence are hypodontia and taurodontism. Mestrovic et al. (38.6%) (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), Acerbi et al. (60%) (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), Moraes et al. (53.05%) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), Sekerci et al. (29%) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) and Bamba et al. (65%) (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) reported the presence of hypodontia most frequently in children with Down syndrome in their study, Bell et al. (36.4%) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), Alp\u0026ouml;z and Eronat (66%) (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and et al, Moraes et al. (85,71) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) reported taurodontism as one of the most common anomalies observed in children with Down syndrome in their study results similar to this study. Cuoghi et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) reported microdontia as the most common anomaly together with hypodontia (16%) in their study with a prevalence of 16%. Sekerci et al. showed that microdontia was the most commonly observed anomaly after hypodontia and taurodontism. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) In the present study, the most commonly observed anomalies in children with Down syndrome were hypodontia, taurodontism and microdontia. The present findings are in parallel with the studies in the literature.\u003c/p\u003e\u003cp\u003eIn their study, Cuoghi et al. found that the prevalence of dental anomalies in individuals with Down syndrome was higher than in the normal population. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) This was also reported in similar studies in the literature. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) Sekerci et al. reported that the prevalence of dental anomalies in individuals with Down syndrome was 5 times higher. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) In their study with the Turkish pediatric population, the rate of taurodontism was 81%, while Alp\u0026ouml;z et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) found 66%. In the present study, this rate was determined as 36% due to the use of different sample sizes in different regions of Turkiye. However, dental anomalies were observed to be higher in the DS group compared to the healthy children group in accordance with the literature. In addition, by forming a control group in the present study; DS group and healthy children could be compared in the same population by providing standardization. We think that this method provides more objective results compared to the studies mentioned above.\u003c/p\u003e\u003cp\u003eIn the present study, no statistically significant relationship was found between the presence of dental anomaly and gender. This finding is highly similar to similar studies in the literature. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eIn the literature, there are few studies examining dental age in individuals with Down syndrome.\u003c/p\u003e\u003cp\u003e(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) In the present study, dental age was found to be lower than chronic age in both groups, regardless of gender, but not statistically significant. These findings support the results of Moreas et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) In a previous study, it was reported that although dental ages within normal limits comparable to chronic age were observed in the majority of individuals with DS, both early and delayed ages were present. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) Our results confirmed these findings using a different method. In our sample with an age group of 5\u0026ndash;14 years, dental age was determined within normal limits, although early age was observed in the 5-year age group and delayed age in the other groups.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eThe study has several limitations. Although anomalies that can be detected by radiography are examined when evaluating dental tissue anomalies, supporting panoramic radiographs with clinical observations will reveal more precise results.\u003c/p\u003e\u003cp\u003eIt is seen that panoramic radiographs are used in various studies for age determination with the Nolla method. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) However, it is reported in the literature that supporting panoramic radiographs with intraoral and lateral skull radiographs may provide more accurate readings. (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) Intraoral films were also utilized in the study, especially when evaluating the anterior region. However, since cephalometric films are not preferred for routine examination and extra films were not requested from the patients in this study, this evaluation could not be performed.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn our study, the prevalence of dental anomalies was higher in children with Down syndrome. In both groups, taurodontism and hypodontia were the most common anomalies. In addition, taurodontism and hypodontia were statistically significant in the comparison of the two groups. There was no relationship between gender and the presence of anomalies and dental age. Although Nolla tooth age was found to be lower than chronic age in both groups; it was found to be higher in some age groups. There was no statistically significant finding between Nolla tooth age and the presence of syndrome. Additional studies with increased sample size are recommended to support our findings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eFunding: No author has a financial or proprietary interest in any material or method mentioned.\u003c/p\u003e\n\u003cp\u003eConflicts of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.\u003c/p\u003e\n\u003cp skip=\"true\"\u003eEthics approval and consent to participate: The retrospective study was approved by the Authors University\u0026rsquo;s Non-Invasive Clinical Practices Ethics Committee. (2022/668) This study was designed as a retrospective review of patient radiographs. It is not a clinical trial, so clinical trial registration was not required. The clinical record does not include a trial registration number or registration data.\u003c/p\u003e\n\u003cp\u003eConsent for publication: No, the results/data/figures in this manuscript have not been published elsewhere, nor are they under consideration (from you or one of your Contributing Authors) by another publisher.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: All of the material is owned by the authors and/or no permissions are required.\u003c/p\u003e\n\u003cp\u003eCode availability: Not applicable\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: Study conception and design: İ.C, E.K ; acquisition of data: İ.C; analysis and interpretation of data: İ.C, E.K; drafting of manuscript: İ.C, E.K,; critical revision: E.K\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e-Pueschel SM. A historicalviewpoint: Downsyndromegrowingandlearning. Pueschel SM, editor. Canning, Murphy, Zaumer, AndrewsandMcMeel, Inc. 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Med Oral Patol Oral Cir Bucal. 2012;17:871\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e-Moraes MEL, Bastos MS, Santos LRA, Castilho JCM, Moraes LC, Filho M, E. Dental age in patients with Down syndrome. Brazilian OralResearch. 2007;21:259\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ede Moraes -MariEL. Luiz Cesar de Moraes, Mayra Cardoso, Weber Ursi, Sergio Lucio Pereira de Castro Lopes. Age assessment based on dental calcification in individualswith Down syndrome. Res Dev DisabilitiesVolume. November 2013;34(11):4274\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDiz -P, Limeres J, Salgado AFP, Tomas I, Delgado LF, Varguez E, et al. Correlation between dental maturation and chronological age inpatients with cerebral palsy, mental retardation and Down syndrome. Res Dev Disabil. 2011;32:808\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKurita -LM, Menezes AV, Casanova MS, Haiter Neto F. Maturity as an indicator of chronological age: Radiographic assessment of dental age in a Brazilian population. J Appl Oral Sci. 2007;15:99\u0026ndash;104.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Dental anomalies, Dental age, Down Syndrome","lastPublishedDoi":"10.21203/rs.3.rs-7706517/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7706517/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBACKGROUND\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDental problems in Down Syndrome are among the most easily detected findings. When the studies in the literature were considered, it was seen that not all developmental anomalies were examined. The aim of this study was to examine more anomalies and compare them with the control group and to obtain more information about the dental findings of Down syndrome by including dental age in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMATERIALS AND METHODS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn our study, panaromic images and, if available, anterior periapical films of 61 Down syndrome and 61 age-matched non-syndromic pediatric patients were analyzed. The dental anomalies of the patients were determined in terms of size, shape, number and texture, and the age of tooth development of both groups was compared using the Nolla method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFINDINGS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDental shape anomalies were numerically higher in patients with Down syndrome except for dens evaginatus, whereas they were statistically significantly higher only in taurodontism. The frequency of hyperdontia and hypodontia, both singly and in combination, was higher in patients with Down syndrome than in healthy patients. Tissue and size anomalies in patients were also observed to be higher in patients with Down syndrome.Although dental age was found to be older in patients with Down syndrome, it was not statistically significant. In the statistical analysis specific to age groups, a statistically significant difference was observed only in the age group of 8 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONCLUSIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIt was showed that in our study ,the prevalence of dental anomalies was higher in children with Down syndrome There was no significant relationship between dental age and the presence of the syndrome. Additional studies with an increased sample size are recommended to support our findings. In this way, it is aimed to improve the current service quality by increasing the existing knowledge about pediatric patients with Down syndrome.\u003c/p\u003e","manuscriptTitle":"What Effect Does Down Syndrome Have on Dental Anomalies and Dental Age in Pediatric Patients?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-15 16:37:01","doi":"10.21203/rs.3.rs-7706517/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-31T11:35:33+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-20T19:42:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-20T00:02:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"212876893831607644839327902930167443559","date":"2026-03-19T07:08:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"339162335707340792075271040021440709643","date":"2026-03-18T12:21:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"159515009928370728537662632125282819622","date":"2026-02-22T12:06:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"312605197491420637219335731736680612842","date":"2025-12-23T16:18:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-20T14:53:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"201979846322954230265265565456658571933","date":"2025-12-10T14:35:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-10T00:52:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-02T07:53:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-09T04:26:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-09T04:25:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-09-24T18:56:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"19ac00ee-9bc9-4d92-9c37-7650ad4e2dc8","owner":[],"postedDate":"December 15th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-07T13:40:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-15 16:37:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7706517","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7706517","identity":"rs-7706517","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}