The dentition: the outcomes of morphogenesis leading to variations of tooth number, size and shape
The dentition: the outcomes of morphogenesis leading to variations of tooth number, size and shape
复制标题
DOI：
10.1111/adj.12160
复制
发表时间：
2014-06-01
影响因子：
2.1
通讯作者：
Townsend, G. C.
中科院分区：
文献类型：
--
作者：
Brook, A. H.;Jernvall, J.;Townsend, G. C.
牙齿数量、大小和形状的变化在许多牙科学科中都具有临床重要性。早期诊断可以实现最佳的患者管理和治疗计划，并在适当的时候进行干预，以防止发育过程中的并发症，从而减少以后的治疗需求。了解牙齿形态发生的过程和结果的变化是多学科临床团队治疗方法的重要贡献。牙齿的数量、大小和形状是在牙齿形成的起始和形态发生阶段决定的。在启动和形态发生的整个过程中重复信号的分子证据在临床上反映在数量、大小和形状的异常的关联上。这种联系已经从流行病学证据中建立了统计模型，并被人类牙科研究模型的2D和3D测量所证实。在缺牙的个体中，形成的牙齿比人群的平均值小，通常表现为减少和简化的形状。相比之下，在有多生牙齿的个体中，其他牙齿比平均大，可能会显示出增强的形状。对人类的临床观察和对实验室动物的研究引发了牙列内形态发生场的概念。这些发现也可以被认为是反映基因表达领域的，已经被发展为并入了场理论、克隆理论和同源盒子理论。发育异常的临床分布倾向于遵循这些领域或地区的模式。改善对这些异常患者的护理不仅来自于利用一个多学科的临床团队，还将通过扩大方法来包括其他相关的科学学科。
The clinical importance of variations of tooth number, size and shape is seen in many dental disciplines. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need. Understanding the process of dental morphogenesis and the variations in outcomes is an important contribution to the multidisciplinary clinical team approach to treatment.Tooth number, size and shape are determined during the initiation and morphogenetic stages of odontogenesis. The molecular evidence of repetitive signalling throughout initiation and morphogenesis is reflected clinically in the association of anomalies of number, size and shape. This association has been statistically modelled from epidemiological evidence and confirmed by 2D and 3D measurement of human dental study casts. In individuals with hypodontia, the teeth that are formed are smaller than the population mean and often show reduced and simplified shape. In contrast, in individuals with supernumerary teeth, the other teeth are larger than average and may show an enhanced shape.Clinical observations in humans and studies of laboratory animals gave rise to the concept of morphogenetic fields within the dentition. The findings, which can also be considered as reflecting gene expression territories, have been developed to incorporate field, clone and homeobox theories. The clinical distribution of developmental anomalies tends to follow the pattern of these fields or territories.Improved care for patients with these anomalies will come not only from utilizing a multidisciplinary clinical team but also by expanding the approach to include other relevant scientific disciplines.