Radiographic assessment of dental anomalies in children: a systematic review

Abstract

Background and objectives. Dental anomalies (DAs) affect tooth number, shape, and structure and can have an impact on oral health and esthetics. Early detection during childhood is important for preventing complications such as malocclusion and caries. This systematic review aimed to synthesize evidence on the prevalence and types of DAs in nonsyndromic pediatric populations assessed radiographically. Materials and methods. Following the PRISMA guidelines, a systematic search was conducted in PubMed, Google Scholar, and the Cochrane Library for studies published from January 2015 to September 2025. Eligible studies were observational studies involving participants aged ≤20 years in whom DAs were assessed using radiographic imaging. Based on the PECOS criteria, 15 observational studies involving radiographic assessment were selected from an initial 3,655 records. The methodological quality of the included studies was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data. Results. The overall prevalence of DAs, reported in 11 studies, ranged from 1.8% to 29.8% (8.2-29.8% in a sensitivity analysis excluding two studies that only partially met the eligibility criteria). Hypodontia was the most frequently reported anomaly, with a prevalence ranging from 0.5% to 9.7% (4.2-9.7% in 12 of the 14 studies reporting hypodontia), frequently affecting mandibular premolars and maxillary lateral incisors. The prevalence of supernumerary teeth ranged from 0.3% to 8.1%, with mesiodens being the most common type. Taurodontism ranged from 0.02% to 2.8%. Other anomalies, such as microdontia, fusion, and dens invaginatus, were generally reported at low prevalence (<4%). Panoramic radiography was the most commonly used imaging modality. Heterogeneity in the reported results was attributed to differences in diagnostic criteria, age ranges, clinical settings, and regional demographics. Conclusions. Hypodontia was the most frequently reported DA in children, followed by supernumerary teeth and positional anomalies such as impaction and ectopic eruption, although the reported prevalence varied widely across populations and settings. Early radiographic identification, when clinically indicated, may facilitate multidisciplinary management; however, standardized diagnostic criteria are needed to improve the comparability of prevalence data across populations.