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Objetivo: Esta revisão integrativa da literatura tem como principal objetivo analisar de forma aprofundada a relação entre a agenesia dentária não-sindrómica e o desenvolvimento das más oclusões, especialmente no que diz respeito às Classes I, II e III esquelética. Através da comparação entre diferentes estudos clínicos e cefalométricos, pretende-se compreender de que forma a presença, a localização e a severidade das agenesias influenciam o crescimento craniofacial e a discrepância maxilo-mandibular. Materiais e métodos: Foi realizada uma pesquisa em bases de dados eletrónicas, nomeadamente PubMed, ScienceDirect, B-On e Cochrane Library. Foram incluídos artigos publicados entre 2010 e 2024, com amostras de pacientes que apresentavam agenesia dentária não-sindrómica. Os estudos selecionados basearam-se em análises cefalométricas, exames radiográficos e avaliação clínica para a determinação da relação entre agenesia dentária e más oclusões.
Resultados: Os estudos analisados revelaram que a agenesia de dentes permanentes, particularmente dos terceiros molares, pré-molares e incisivos laterais, pode estar associada a padrões esqueléticos alterados. Estudos demonstraram uma maior prevalência de Classe III esquelética em indivíduos com ausência de terceiros molares, geralmente associada a um menor ângulo SNA e um padrão hipodivergente. As agenesias dos pré-molares mostraram resultados heterogéneos, alguns estudos apontam uma associação significativa com a Classe III, enquanto que outros não identificaram correlações claras com nenhum tipo específico de má oclusão. A divergência pode ser explicada pelos diferentes critérios de avaliação (Classe de Angle vs Classe esquelética). A literatura indica que a ausência dos incisivos laterais, especialmente superiores, pode alterar a morfologia das arcadas e influenciar o crescimento maxilar, contribuindo tanto para padrões de Classe II como de Classe III. Estudos demonstraram uma correlação linear entre o número de dentes ausentes e a gravidade das alterações esqueléticas. Quanto maior o número de agenesias, maior a tendência para padrões hipodivergentes e Classe III. A ausência de dentes compromete o desenvolvimento do osso alveolar e modifica significativamente os ângulos cefalométricos como SNA, SNB e ANB.
Conclusão: A agenesia dentária, sobretudo quando severa, pode influenciar significativamente o desenvolvimento das más oclusões esqueléticas, nomeadamente nos padrões Classe III. No entanto, esta relação não é linear nem universal, sendo modulada por fatores como o tipo de dente ausente, a sua localização, o sexo, a etnia e os mecanismos compensatórios do paciente. Assim, reforça-se a importância de uma avaliação ortodôntica precoce, individualizada e multidisciplinar, que considere não só o número de agenesias, mas também a análise cefalométrica e o padrão de crescimento facial de cada paciente.
Objective: This integrative literature review has as its main objective to analyze in depth the relationship between non-syndromic dental agenesis and the development of malocclusions, especially with regard to skeletal Classes I, II and III. By comparing different clinical and cephalometric studies, we aim to understand how the presence, location and severity of agenesis influence craniofacial growth and maxillomandibular discrepancy. Materials and methods: A search was performed in electronic databases, namely, PubMed, ScienceDirect, B-On and Cochrane Library. Articles published between 2010 and 2024, with samples from patients who presented non-syndromic dental agenesis, were included. The selected studies were based on cephalometric analyses, radiographic examinations and clinical evaluation to determine the relationship between dental agenesis and malocclusions. Results: The analyzed studies revealed that agenesis of permanent teeth, particularly third molars, premolars and lateral incisors, may be associated with altered skeletal patterns. Studies have shown a higher prevalence of skeletal Class III in individuals with absent third molars, generally associated with a smaller SNA angle and hypodivergent pattern. Premolar agenesis showed heterogeneous results, some studies indicate a significant association with Class III, while others did not identify clear correlations with any specific type of malocclusion. The divergence can be explained by the different evaluation criteria (Angle Class vs Skeletal Class). The literature indicates that the absence of lateral incisors, especially upper ones, can alter the morphology of the arches and influence maxillary growth, contributing to both Class II and Class III patterns. Studies have demonstrated a linear correlation between the number of missing teeth and the severity of skeletal changes. The greater the number of agenesis, the greater the tendency towards hypodivergent and Class III patterns. The absence of teeth compromises the development of the alveolar bone and significantly modifies cephalometric angles such as SNA, SNB and ANB. Conclusion: Dental agenesis, especially when severe, can significantly influence the development of skeletal malocclusions, notably in Class III patterns. However, this relationship is neither linear nor universal, being modulated by factors such as the type of missing tooth, its location, sex, ethnicity and the patient's compensatory mechanisms. Thus, the importance of an early, individualized and multidisciplinary orthodontic evaluation is reinforced, which considers not only the number of agenesis, but also the cephalometric analysis and the facial growth pattern of each patient.
Objective: This integrative literature review has as its main objective to analyze in depth the relationship between non-syndromic dental agenesis and the development of malocclusions, especially with regard to skeletal Classes I, II and III. By comparing different clinical and cephalometric studies, we aim to understand how the presence, location and severity of agenesis influence craniofacial growth and maxillomandibular discrepancy. Materials and methods: A search was performed in electronic databases, namely, PubMed, ScienceDirect, B-On and Cochrane Library. Articles published between 2010 and 2024, with samples from patients who presented non-syndromic dental agenesis, were included. The selected studies were based on cephalometric analyses, radiographic examinations and clinical evaluation to determine the relationship between dental agenesis and malocclusions. Results: The analyzed studies revealed that agenesis of permanent teeth, particularly third molars, premolars and lateral incisors, may be associated with altered skeletal patterns. Studies have shown a higher prevalence of skeletal Class III in individuals with absent third molars, generally associated with a smaller SNA angle and hypodivergent pattern. Premolar agenesis showed heterogeneous results, some studies indicate a significant association with Class III, while others did not identify clear correlations with any specific type of malocclusion. The divergence can be explained by the different evaluation criteria (Angle Class vs Skeletal Class). The literature indicates that the absence of lateral incisors, especially upper ones, can alter the morphology of the arches and influence maxillary growth, contributing to both Class II and Class III patterns. Studies have demonstrated a linear correlation between the number of missing teeth and the severity of skeletal changes. The greater the number of agenesis, the greater the tendency towards hypodivergent and Class III patterns. The absence of teeth compromises the development of the alveolar bone and significantly modifies cephalometric angles such as SNA, SNB and ANB. Conclusion: Dental agenesis, especially when severe, can significantly influence the development of skeletal malocclusions, notably in Class III patterns. However, this relationship is neither linear nor universal, being modulated by factors such as the type of missing tooth, its location, sex, ethnicity and the patient's compensatory mechanisms. Thus, the importance of an early, individualized and multidisciplinary orthodontic evaluation is reinforced, which considers not only the number of agenesis, but also the cephalometric analysis and the facial growth pattern of each patient.
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Palavras-chave
Agenesia dentária Hipodontia Más oclusões Classe esquelética Classe I Classe II e Classe III Dental agenesis Hypodontia Malocclusions Skeletal class Class I Class II and Class III