46 - Tooth Agenesis in Individuals with Down Syndrome: A Meta-Analysis

Abstract:

Purpose: This study aimed to conduct a systematic review and meta-analysis to compare the prevalence of permanent tooth agenesis between individuals with and without Down syndrome (DS).

Methods: A literature search of indexed databases (PubMed, Web of Science, and Embase) was conducted without language or age restrictions up to and including January 2026. Cross-referencing was used to identify additional articles. The eligibility criteria included observational studies with original data that used dental radiographs to assess the prevalence of permanent tooth agenesis among individuals with DS. A random-effects meta-analysis using the Mantel–Haenszel estimator was performed to evaluate the association between agenesis and DS, based on odds ratios (ORs) with 95% confidence intervals (CIs).

Results: The literature search yielded 481 records, of which 28 full-text articles were reviewed. Seventeen studies comprising 6,677 individuals met the selection criteria and were included in the meta-analysis. The meta-analysis revealed a statistically significant association between agenesis and DS (OR, 26.06; 95% CI, 11.38–59.70). Among individuals with DS, the pooled prevalence of permanent tooth agenesis (excluding third molars) was 54%. The most commonly missing teeth were the maxillary lateral incisors and mandibular second premolars, followed by the maxillary second premolars. Considerable heterogeneity was observed among the included studies (P < .0001).

Conclusions: Individuals with DS are more likely to present with congenitally missing permanent teeth compared with individuals without DS. These individuals require long-term, multidisciplinary treatment plans to ensure a functional and esthetic dentition.

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