Oral development is a complex adaptive system influenced by genetic, epigenetic and environmental factors. The dental arch develops from 6 weeks in utero until adult life, forming an accessible record to study general growth and development. Increased tooth size in female dizygotic opposite-sex (DZOS) twins compared with female dizygotic same-sex (DZSS) twins provides evidence for the masculinisation of females gestated with a male co-twin, possibly due to the intrauterine influence of male sex hormones: the “Twin Testosterone Transfer” (TTT) hypothesis. This study aimed to investigate the potential influence of intrauterine male hormones on dental arch size of female DZOS twins. Serial dental models of the primary and permanent dentitions of 69 female DZOS and DZSS twins were examined. Intercanine width, intermolar width, arch length and arch circumference were measured using a customised 2D image analysis system. Unpaired t-tests showed significant differences for mandibular intercanine width (p = 0.03; effect size = 0.6) and borderline differences for mandibular intermolar width and arch circumference (p = 0.05; effect size = 0.5). No significant differences were found in the permanent dentition. These findings provide support for the TTT hypothesis with some arch dimensions being larger in female DZOS twins. We have developed a model of assessing the effects of intrauterine male hormones on the epigenetic changes that last into postnatal life. Our evidence suggests that this is a moderate effect possibly interacting with numerous other environmental factors that may influence arch size.
complex adaptive system, epigenetics, sex chromosomes, sexual dimorphism, twins
 Brook, A., O’Donnell, M.B., Hone, A., Hart, E., Hughes, T., Smith, R. & Townsend, G.C., General and craniofacial development are complex adaptive processes influenced by diversity.
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