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O presente trabalho versa sobre o diagnóstico e a abordagem ortodôntica das anomalias dentárias, enfatizando os aspectos etiológicos que definem tais irregularidades de desenvolvimento. Parece existir uma inter-relação genética na determinação de algumas dessas anomalias, considerando-se a alta frequência de associações. Um mesmo defeito genético pode originar diferentes manifestações fenotípicas, incluindo agenesias, microdontias, ectopias e atraso no desenvolvimento dentário. As implicações clínicas das anomalias dentárias associadas são muito relevantes, uma vez que o diagnóstico precoce de uma determinada anomalia dentária pode alertar o clínico sobre a possibilidade de desenvolvimento de outras anomalias associadas no mesmo paciente ou em outros membros da família, permitindo a intervenção ortodôntica em época oportuna.

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Objective – This study aims to evaluate the epidemiological characteristics of a sample of patients with agenesis of second premolars, as well as to investigate its association with agenesis of other permanent teeth. Material and methods – A Brazilian sample of 203 patients aged from 8 to 22 years was selected, all patients presenting agenesis of at least 1 second premolar. Patient age, gender and ethnicity were recorded, as well as the history of extraction of permanent teeth and associated agenesis of other permanent teeth. Results: – Most individuals presenting second premolar agenesis were female (66%), a sex ratio of 2F:1M. The frequency of second premolar agenesis was higher in the mandible (61.5%) than in the maxilla (16.7%), while 21.6% of the patients showed second premolar agenesis affecting both arches. The prevalence of unilateral and bilateral agenesis was similar (50%) in the maxilla, while in the mandible 60% of the sample exhibited unilateral agenesis. The mandibular left hemi arch was the most frequently affected. Most of the patients (45.3%) had agenesis of just 1 second premolar. There was a high prevalence of agenesis of other permanent teeth associated with second premolar agenesis, especially of maxillary lateral incisors (16%) and third molars (48%). Conclusion: Agenesis of second premolars was more prevalent in females and at the left side of the mandibular arch and was often associated with agenesis of other permanent teeth.