The prevalence of hypodontia varies in different ethnic groups and regions in the

world (35. Polder BJ, Vant Hof MA, Van der Linden FP, Kuijpers- Jagtman AM. A
meta-analysis of the prevalence of dental agenesis of permanent teeth. Community
Dent Oral Epidemiol. 2004;32:217226 ) The prevalence of hypodontia in orthodontic
patients has been reported differently. Excluding the
third molar, hypodontia ranges from 2.6% in Turkey5,
to 5.5% in Mexico13, 6.3% in Brazil9, 8.5% in
Japan7, 11.1% in Korea14, 14.7% in Hungary8,
to 26.4% in Thais .(4798)

Based on information, this is the first time such study performed in Iraq with
panoramic radiograph for those patients visits privates and government dental clinics
for orthodontic treatment.

The results of the this study showed a prevalence of 6.6 per cent of hypodontia in
orthodontic patients. Our finding is less than prevalence of hypodontia in Australian
orthodontic patients (8.1 per cent) (Thongudomporn and Freer, 1998), Japanese
orthodontic patients (8.5 percent) (Endo et al., 2006), Lithuanian orthodontic patients
(8%) by Trakinien et al., (2013 Vahid-Dastjerdi et al. (2010) 9.1%)). While, the prevalence in
Mexican orthodontic patients was 2.7 percent (Meza, 2003), which is lower than the
prevalence observed in the present study. Our finding is near to prevalence of study
done in the Federal District, Brazil by Raquel Ribeiro Gomes which is 6.3%. (Gomes et
al., 2009).There are important differences among countries in the organization of
orthodontics for children and as such there will be differences in the availability and
uptake of orthodontics. The great range of prevalence for hypodontia (1.69.6 per cent)
observed in different population may be due to geographic differences (Haavikko,
1971; Seow and Lai, 1989; Townsend et al., 1995; Kotsomitis and Freer, 1997; Arte
and Pirinen, 2003).

Prevalence of hypodontia in our study is comparable

to the results of Sisman et al.[15] (7.54%), Topkara
et al.[24] (6.77%), and Cantekin et al.[12] (6.2%) in
orthodontic populations, and is higher than that
reported in a pediatric orthodontic population in
Venezuela (4%).[13] However, prevalence of hypodontia
in our population is within range of Asian populations
reported in different studies.[3,4,12,15,23,25]

Hypodontia was more frequently found in females with no statistical difference and
this is agree with Trakinien et al ( 2013 ), (Grahnn,
1956; Haavikko, 1971; Lai and Seow, 1989; Thongudomporn and Freer, 1998;
Fekonja, 2005; Endo et al., 2006). While Bckman and Wahlin (2001) and Brook
(1984) found significant difference between genders (302).

Some authors such as Fekonja,[17] Gomes et al.,[26] Endo

et al.,[9] Celikoglu et al.,[27] Medina,[13] and Cantekin
et al.[12] observed higher prevalence of hypodontia
in females. The prevalence of tooth agenesis in
females was also reported to be 1.37 times higher
than in males in North American Caucasians.[4] It
has been mentioned that this higher prevalence of
hypodontia in females might be associated with
biological differences and makes a greater orthodontic
treatment need, that increases their seeking for
treatment due to aesthetical concerns. However,
several investigations found higher prevalence in
males[15,28] and some reported no difference between
gender.[10] ejd
The maxillary lateral incisor was found to be the most frequently missing tooth in the
current study. This is in accordance with (Mller et al., 1970; Ciamponi and Frassei,
1999; Meza, 2003; Fekonja, 2005; Gbris K et al 2006, Sisman Y et al, 2007, Gomes RR 2010 Vahid-
Dastjerdi et al., 2010). The maxillary lateral
incisor was the most frequent in many studies.3, 5, 9, 13 -15(4798)
There is some variation in description of the most common missing tooth, excluding
third molars. The mandibular second premolar is the most common missing tooth
(Rlling, 1980; Thongudomporn and Freer, 1998; Bckman and Wahlin, 2001; Polder
et al., 2004; Mattheeuws et al., 2004; Endo et al., 2006; Farhat A 2010).

In addition, differences between populations of patients seeking orthodontic treatment

may possibly reflect different psycho-social aspects between regions. It is thus
probable that in countries where smile aesthetics are
highly valued, lateral incisor hypodontia may motivate
parents and patients to seek orthodontic treatment.(Gomez et al, 2009).

The location of missing teeth differs in all studies. Some authors found that hypodontia
appears equally in both jaws; others confirm that the number
of missing teeth was greater in the mandible than in the maxilla (20). In our study, it
was more in maxilla (64.28%) than mandible. Also, the prevalence of hypodontia in
the maxillary arch was higher than in mandibular
arch, that is consistent with most of the previous
studies.[14,21,27] However, there are studies which had
found a greater missing rate in the mandible.[10] Consistent with the findings of
several studies,[13-15]

In majority studies the distribution of missing teeth between the right and left sides
was the same (21). In our study teeth were missing more often on the left which is in
accordance with Farhat Amin (20).

we found majority of patients had one or two teeth missing which is agree with (Farhat
A,2010; Sisman Y et al, 2007). In our study prevalence of oligodontia was 0.33%but in
Hungary orthodontic patients prevalence of oligodontia was 1.04% (Gbris K et al., 2006).
As we found there are some differences in the results of analogical studies and they
could be related to different sample selection. It is also possible that different
populations vary due to genetic variability and different exposure to environmental
factors. All authors agree that tooth number anomalies are often seen in the practice of
orthodontist. 132-02

As tooth agenesis is the most common anomaly in the

development of the human dentition, many studies
are found on the prevalence of hypodontia in different
ethnic groups.[3,4,8-10] The patients age might confound the results.
Beginning of calcification of some teeth may occur after the age 9 or 10.
Mineralization of premolars may be even delayed.[4] Therefore, detection of missing
teeth before age 10 might cause false and unreliable results. Disruption of the findings
in terms of the most frequently missing teeth can also affects the results due to delayed
development of premolars. Thats why higher prevalence of premolar missing has been
reported in some studies.[15,23]
Nevertheless,
The missing teeth were more often absent
bilaterally (73.11%), and only 26.89% were unilaterally
missed, with a tendency of higher prevalence in the
left side. Goya et al.,[3] Endo et al.,[9] Medina,[13] Sisman
et al.[15] and Silva meza[16] also reported that missing
teeth are mostly found bilaterally, whereas Fekonja[15]
observed more prevalence of missing teeth in right
side.. EJD

Furthermore, the prevalence observed in this study was relatively higher than that in
Turkish (4.6%) (10) and sudanes (5.1%) orthodontic patients ( 1]
In this study, the females show a higher prevalence of hypodontia than males 7.75%%
females 5.05% males), which is in accordance with the majority of previous
reports.[17,20,21,25] However, in the German study; the percentage was equally
distributed between the females and males.[16] Nevertheless, the literature does not
confirm this.

In this study, the most frequent congenitally missing teeth were the upper lateral
incisors (42,68%) followed by lower second premolar (19.51%), upper second
premolars (14,63%), subsequently followed by the lower centra incisors (9.75%). On
the other hand, the least tooth to be found missing were the upper first premolar
(4.87%) . this result was partially in agreement with the result obtained by FIGHAN
in previous study carried out for Erbil school children. She reported that permanent
maxillary lateral incisors the most commonly involved tooth was (24%) followed by
the permanent mandibular second premolar (20%) and then the permanent maxillary
second premolar (9%) of total missing teeth

1. Prevalence of hypodontia in a sample of Sudanese orthodontic patients Hassan DA, Abuaffan AH, Hashim HA

2. Fekonja A. Hypodontia in orthodontically treated children. Eur J Orthod.

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11. Endo T, Ozoe R, Yoshino S, Shimooka S. Hypodontia patterns and variations in
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1003. [PubMed]

16. Behr M, Proff P, Leitzmann M, Pretzel M, Handel G, Schmalz G, et al. Survey of

congenitally missing teeth in orthodontic patients in Eastern Bavaria. Eur J Orthod.
2011;33:3236. [PubMed]
17. Gomes RR, da Fonseca JA, Paula LM, Faber J, Acevedo AC. Prevalence of
hypodontia in orthodontic patients in Brasilia, Brazil. Eur J Orthod. 2010;32:30206.
[PubMed]

20. AL-Emran S, Wisth PJ, Be OE. Prevalence of malocclusion and need for
orthodontic treatment in Saudi Arabia. Community Dent Oral Epidemiol.
1990;18:25355. [PubMed]
21. Afify AR, Zawawi KH. The prevalence of dental anomalies in the Western region
of Saudi Arabia. ISRN Dent. 2012;2012:837270. [PMC free article] [PubMed]
22. Nganga RN, Nganga PM. Hypodontia of permanent teeth in a Kenyan
population. East Afr Med J. 2001;78:20003. [PubMed]
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