Dental development is a complex adaptive system (CAS) in which genetic, epigenetic and environmental factors interact during different developmental stages to influence final tooth size and shape. From these complex interactions, a self-regulating and self-organising system emerges with spatiotemporal, multidimensional, multilevel and multifactorial components. The aim of this study was to quantify the influence of intrauterine male hormones on the mesiodistal dimension of permanent teeth by studying females from opposite-sex (OS) and same-sex (SS) twin pairs to explore dental development as a CAS. A custom-designed 2D image analysis system was used to measure the mesiodistal dimension from the occlusal view in each permanent tooth of 30 dizygotic OS and 30 dizygotic SS female twin pairs. Linear mixed models were used to quantify the differences in tooth size and shape. The mean mesiodistal tooth dimension was greater in the OS cohort for the majority of the permanent dentition. These findings reflected the complex interactions between genetic, epigenetic and environmental factors and their outcomes during development. The results indicated the transmission of the male hormones to the female in utero influencing her endocrine system, leading to epigenetic changes and so affecting gene expression. This demonstrated prenatal sex hormones as an environmental agent influencing multiple interactions within a developmental CAS.
complex adaptive systems, dental development, epigenetic, genetic, phenomics, prenatal sex hormones, sexual dimorphism, Y chromosome
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