Exploring the Relationship Between Oligodontia and Hair Abnormalities: A Study Overview

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Oligodontia, characterized by the congenital absence of 6 or more teeth in the deciduous or permanent dentition, is a relatively rare condition affecting approximately 0.01-0.3% of the population. This dental anomaly can occur in isolation or as part of syndromic manifestations, often associated with ectodermal dysplasia (ED), which affects structures derived from the ectoderm, such as hair, nails, and sweat glands. A recent study aimed to evaluate hair abnormalities in orthodontic patients diagnosed with oligodontia.¹

Materials and Methods

The study included all orthodontic patients diagnosed with oligodontia in the permanent dentition from the Department of Orthodontics, Medical University in Warsaw, Poland, over the last 20 years. Inclusion criteria were an age of over 6 years, the congenital absence of at least 6 permanent teeth, and no clinical symptoms of onychodysplasia, dyshidrosis, or other congenital dentofacial deformities.

Hair examination comprised clinical evaluation, trichoscopy, trichogram, and polarized light microscopy. Trichoscopy involved the use of a dermoscope with magnifications of 20-70 times to examine hair and scalp structures. The trichogram evaluated the hair cycle phases by examining approximately 100 hair shafts from various scalp areas. Polarized light microscopy assessed hair shaft structure for congenital disorders like trichothiodystrophy and monilethrix.

Results

Hair abnormalities were found in 68% of patients. The most common issues included hypotrichosis, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa, and pseudomoniletrix. Pigmentary disturbances, such as heterogeneity in shaft color and loss of pigment, were observed in 52% of patients. No cases of severe hair disorders like trichothiodystrophy were noted.

Discussion

Investigators wrote that the low prevalence of oligodontia makes it challenging to conduct large-scale studies. The study’s findings indicate a higher incidence of hair abnormalities among oligodontia patients, suggesting a potential link to ectodermal dysplasia, even in patients with minimal clinical symptoms. Previous studies have shown a significant correlation between oligodontia and ectodermal abnormalities. Hair, nail, and sweat gland abnormalities affect 57% of patients with oligodontia.

Hair examination methods like trichoscopy and trichogram are crucial non-invasive diagnostic tools. Trichoscopy allows real-time observation of hair and scalp, providing valuable insights into hair shaft and follicular unit structures. Trichogram helps assess hair cycle phases, identifying deviations indicative of underlying conditions.

In this study, the most common hair abnormalities included hypotrichosis and telogen effluvium, with structural abnormalities being less frequent. The presence of androgenetic alopecia in one patient was considered a comorbid condition. Genetic testing was not performed due to the low clinical expression of ectodermal symptoms. However, genetic mutations in genes such as EDA, PAX9, and WNT10A have been associated with both ectodermal dysplasia and isolated oligodontia.

Conclusions

Researchers concluded that hair abnormalities are prevalent among patients with oligodontia in the permanent dentition. Trichoscopy and trichogram are effective non-invasive diagnostic tests that can help differentiate between isolated and syndromic oligodontia, especially in patients with subtle ectodermal symptoms. Further research with larger sample sizes and multicenter collaborations is necessary to establish definitive clinical criteria for diagnosing hair abnormalities related to oligodontia. Genetic testing could provide additional insights into the syndromic nature of the condition, aiding in better diagnosis and management.Multidisciplinary care for oligodontia is common², and this study shows that adding a dermatology clinician to the treatment plan could be helpful.By identifying these hair abnormalities early, dermatology clinicians can play a pivotal role in diagnosing and managing potential underlying syndromic conditions, ultimately improving patient outcomes and quality of life.

References

1. Zadurska M, Rakowska A, Czochrowska E, et al. Hair Evaluation in Orthodontic Patients with Oligodontia. Diagnostics (Basel). 2024;14(9):945. Published 2024 Apr 30. doi:10.3390/diagnostics14090945
2. Bural C, Oztas E, Ozturk S, Bayraktar G. Multidisciplinary treatment of non-syndromic oligodontia. Eur J Dent. 2012;6(2):218-226.