Introduction: Enamel hypoplasia causes a reduction in the thickness of affected enamel and is one of the most common dental anomalies. This defect is caused by environmental and/or genetic factors that interfere with tooth formation, emphasizing the importance of investigating enamel hypoplasia on an epidemiological and genetic level. Methods: A genome-wide association of enamel hypoplasia was performed in multiple cohorts, overall comprising 7,159 individuals ranging in age from 7 to 82 years. Mixed models were used to test for genetic association while simultaneously accounting for relatedness and genetic population structure. Meta-analysis was then performed. More than 5 million single-nucleotide polymorphisms were tested in individual cohorts. Results: Analyses of the individual cohorts and meta-analysis identified association signals close to genome-wide significance (p < 5 × 10–8), and many suggestive association signals (5 × 10–8 < p < 5 × 10–6) near genes with plausible roles in tooth/enamel development. Conclusion: The strongest association signal (p = 1.57 × 10–9) was observed near BMP2K in one of the individual cohorts. Additional suggestive signals were observed near genes with plausible roles in tooth development in the meta-analysis, such as SLC4A4 which can influence enamel hypoplasia. Additional human genetic studies are needed to replicate these results and functional studies in model systems are needed to validate our findings.

1.
Thesleff
I
.
The genetic basis of tooth development and dental defects
.
Am J Med Genet A
.
2006 Dec 1
;
140
(
23
):
2530
5
.
2.
Bailleul-Forestier
I
,
Molla
M
,
Verloes
A
,
Berdal
A
.
The genetic basis of inherited anomalies of the teeth
.
Eur J Med Genet
.
2008
;
51
(
4
):
273
91
.
3.
Brook
AH
,
Griffin
RC
,
Townsend
G
,
Levisianos
Y
,
Russell
J
,
Smith
RN
.
Variability and patterning in permanent tooth size of four human ethnic groups
.
Arch Oral Biol
.
2009 Dec
;
54 Suppl 1
:
S79
85
. .
4.
Gerreth
K
,
Zaorska
K
,
Zabel
M
,
Nowicki
M
,
Borysewicz-Lewicka
M
.
Significance of genetic variations in developmental enamel defects of primary dentition in Polish children
.
Clin Oral Investig
.
2018
;
22
(
1
):
321
9
. .
5.
Suckling
GW
.
Developmental defects of enamel: historical and present-day perspectives of their pathogenesis
.
Adv Dent Res
.
1989 Sep
;
3
(
2
):
87
94
. .
6.
Li
Y
,
Navia
JM
,
Bian
JY
.
Caries experience in deciduous dentition of rural Chinese children 3–5 years old in relation to the presence or absence of enamel hypoplasia
.
Caries Res
.
1996
;
30
(
1
):
8
15
. .
7.
Lai
PY
,
Seow
WK
,
Tudehope
DI
,
Rogers
Y
.
Enamel hypoplasia and dental caries in very-low birthweight children: a case-controlled, longitudinal study
.
Pediatr Dent
.
1997 Jan–Feb
;
19
(
1
):
42
9
.
8.
Hong
L
,
Levy
SM
,
Warren
JJ
,
Broffitt
B
.
Association between enamel hypoplasia and dental caries in primary second molars: a cohort study
.
Caries Res
.
2009
;
43
(
5
):
345
53
. .
9.
Lunardelli
SE
,
Peres
MA
.
Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children
.
Braz Oral Res
.
2005 Apr–Jun
;
19
(
2
):
144
9
. .
10.
Seow
WK
,
Ford
D
,
Kazoullis
S
,
Newman
B
,
Holcombe
T
.
Comparison of enamel defects in the primary and permanent dentitions of children from a low-fluoride district in Australia
.
Pediatr Dent
.
2011 May–Jun
;
33
(
3
):
207
12
.
11.
Chauhan
D
,
Chauhan
T
.
Prevalence of developmental defects of enamel in mixed and permanent dentition of 9 and 12 year old children of Himachal Pradesh, India: a cross sectional study
.
Int J Health Allied Sci
.
2013
;
2
:
185
8
.
12.
Robles
MJ
,
Ruiz
M
,
Bravo-Perez
M
,
González
E
,
Peñalver
MA
.
Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain)
.
Med Oral Patol Oral Cir Bucal
.
2013
;
18
(
2
):
e187
93
.
13.
Clarkson
J
.
Review of terminology, classifications, and indices of developmental defects of enamel
.
Adv Dent Res
.
1989 Sep
;
3
(
2
):
104
9
. .
14.
Howe
BJ
,
Cooper
ME
,
Vieira
AR
,
Weinberg
SM
,
Resick
JM
,
Nidey
NL
,
Spectrum of dental phenotypes in nonsyndromic orofacial clefting
.
J Dent Res
.
2015
;
94
(
7
):
905
12
.
15.
Polk
DE
,
Weyant
RJ
,
Crout
RJ
,
McNeil
DW
,
Tarter
RE
,
Thomas
JG
,
Study protocol of the Center for Oral Health Research in Appalachia (COHRA) etiology study
.
BMC Oral Health
.
2008
;
8
:
18
.
16.
Neiswanger
K
,
McNeil
DW
,
Foxman
B
,
Govil
M
,
Cooper
ME
,
Weyant
RJ
,
Oral health in a sample of pregnant women from Northern Appalachia
.
Int J Dent
.
2015
;
2015
:
469376
.
17.
Aiyer
AN
,
Kip
KE
,
Marroquin
OC
,
Mulukutla
SR
,
Edmundowicz
D
,
Reis
SE
.
Racial differences in coronary artery calcification are not attributed to differences in lipoprotein particle sizes: the heart strategies concentrating on risk evaluation (Heart SCORE) study
.
Am Heart J
.
2007 Feb
;
153
(
2
):
328
34
. .
18.
Wang
X
,
Shaffer
JR
,
Zeng
Z
,
Begum
F
,
Vieira
AR
,
Noel
J
,
Genome-wide association scan of dental caries in the permanent dentition
.
BMC Oral Health
.
2012
;
12
:
57
.
19.
Leslie
EJ
,
Carlson
JC
,
Shaffer
JR
,
Feingold
E
,
Wehby
G
,
Laurie
CA
,
A multi-ethnic genome-wide association study identifies novel loci for non-syndromic cleft lip with or without cleft palate on 2p24.2, 17q23 and 19q13
.
Hum Mol Genet
.
2016 Jul 1
;
25
(
13
):
2862
72
.
20.
Howie
BN
,
Donnelly
P
,
Marchini
J
.
A flexible and accurate genotype imputation method for the next generation of genome-wide association studies
.
PLoS Genet
.
2009 Jun
;
5
(
6
):
e1000529
. .
21.
Genomes Project
C
,
Abecasis
GR
,
Auton
A
,
Brooks
LD
,
DePristo
MA
,
Durbin
RM
,
An integrated map of genetic variation from 1,092 human genomes
.
Nature
.
2012 Nov 1
;
491
(
7422
):
56
65
.
22.
Shungin
D
,
Haworth
S
,
Divaris
K
,
Agler
CS
,
Kamatani
Y
,
Keun Lee
M
,
Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data
.
Nat Commun
.
2019
;
10
(
1
):
2773
73
.
23.
Laurie
CC
,
Doheny
KF
,
Mirel
DB
,
Pugh
EW
,
Bierut
LJ
,
Bhangale
T
,
Quality control and quality assurance in genotypic data for genome-wide association studies
.
Genet Epidemiol
.
2010 Sep
;
34
(
6
):
591
602
.
24.
Bennett
SN
,
Caporaso
N
,
Fitzpatrick
AL
,
Agrawal
A
,
Barnes
K
,
Boyd
HA
,
Phenotype harmonization and cross-study collaboration in GWAS consortia: the GENEVA experience
.
Genet Epidemiol
.
2011
;
35
(
3
):
159
73
.
25.
Zhou
X
,
Stephens
M
.
Efficient multivariate linear mixed model algorithms for genome-wide association studies
.
Nat Methods
.
2014
;
11
(
4
):
407
9
.
26.
Kang
HM
,
Sul
JH
,
Service
SK
,
Zaitlen
NA
,
Kong
SY
,
Freimer
NB
,
Variance component model to account for sample structure in genome-wide association studies
.
Nat Genet
.
2010
;
42
(
4
):
348
54
.
27.
Willer
CJ
,
Li
Y
,
Abecasis
GR
.
METAL: fast and efficient meta-analysis of genomewide association scans
.
Bioinformatics
.
2010
;
26
(
17
):
2190
1
.
28.
Ward
LD
,
Kellis
M
.
HaploReg: a resource for exploring chromatin states, conservation, and regulatory motif alterations within sets of genetically linked variants
.
Nucleic Acids Res
.
2012 Jan
;
40
(
Database issue
):
D930
4
. .
29.
Watanabe
K
,
Taskesen
E
,
van Bochoven
A
,
Posthuma
D
.
Functional mapping and annotation of genetic associations with FUMA
.
Nat Commun
.
2017 Nov
;
8
:
1826
.
30.
Pruim
RJ
,
Welch
RP
,
Sanna
S
,
Teslovich
TM
,
Chines
PS
,
Gliedt
TP
,
LocusZoom: regional visualization of genome-wide association scan results
.
Bioinformatics
.
2010 Sep 15
;
26
(
18
):
2336
7
.
31.
Tamura
M
,
Nemoto
E
.
Role of the Wnt signaling molecules in the tooth
.
Jpn Dent Sci Rev
.
2016
;
52
(
4
):
75
83
. .
32.
Liu
M
,
Guan
Z
,
Shen
Q
,
Flinter
F
,
Domínguez
L
,
Ahn
JW
,
Ulk4 Regulates neural stem cell pool
.
Stem Cells
.
2016 Sep
;
34
(
9
):
2318
31
.
33.
Liu
M
,
Xu
P
,
O’Brien
T
,
Shen
S
.
Multiple roles of Ulk4 in neurogenesis and brain function
.
Neurogenesis
.
2017
;
4
(
1
):
e1313646
. .
34.
Nurbaeva
MK
,
Eckstein
M
,
Devotta
A
,
Saint-Jeannet
JP
,
Yule
DI
,
Hubbard
MJ
,
Evidence that calcium entry into calcium-transporting dental enamel cells is regulated by cholecystokinin, acetylcholine and ATP
.
Front Physiol
.
2018
;
9
:
801
.
35.
Lacruz
RS
,
Smith
CE
,
Bringas
P
,
Chen
YB
,
Smith
SM
,
Snead
ML
,
Identification of novel candidate genes involved in mineralization of dental enamel by genome-wide transcript profiling
.
J Cell Physiol
.
2012
;
227
(
5
):
2264
75
.
36.
Kantaputra
PN
,
Chinadet
W
,
Ohazama
A
,
Kono
M
.
Dyschromatosis symmetrica hereditaria with long hair on the forearms, hypo/hyperpigmented hair, and dental anomalies: report of a novel ADAR1 mutation
.
Am J Med Genet A
.
2012
;
158A
(
9
):
2258
65
. .
37.
Cantu
C
,
Pagella
P
,
Shajiei
TD
,
Zimmerli
D
,
Valenta
T
,
Hausmann
G
,
A cytoplasmic role of Wnt/beta-catenin transcriptional cofactors Bcl9, Bcl9l, and Pygopus in tooth enamel formation
.
Sci Signal
.
2017 Feb 7
:
10
(
465
):
eaah4598
.
38.
Juuri
E
,
Saito
K
,
Ahtiainen
L
,
Seidel
K
,
Tummers
M
,
Hochedlinger
K
,
Sox2+ stem cells contribute to all epithelial lineages of the tooth via Sfrp5+ progenitors
.
Dev Cell
.
2012 Aug 14
;
23
(
2
):
317
28
.
39.
Juuri
E
,
Jussila
M
,
Seidel
K
,
Holmes
S
,
Wu
P
,
Richman
J
,
Sox2 marks epithelial competence to generate teeth in mammals and reptiles
.
Development
.
2013 Apr
;
140
(
7
):
1424
32
.
40.
Obara
N
,
Suzuki
Y
,
Irie
K
,
Shibata
S
.
Expression of planar cell polarity genes during mouse tooth development
.
Arch Oral Biol
.
2017
;
83
(
83
):
85
91
. .
41.
van den Oord
EJCG
,
Kuo
PH
,
Hartmann
AM
,
Webb
BT
,
Möller
HJ
,
Hettema
JM
,
Genomewide association analysis followed by a replication study implicates a novel candidate gene for neuroticism
.
Arch Gen Psychiatr
.
2008
;
65
(
9
):
1062
71
.
42.
Taira
TM
,
Lima
V
,
Prado
DS
,
Silva
TA
,
Issa
JPM
,
da Silva
LAB
,
NLRP12 Attenuates inflammatory bone loss in experimental apical periodontitis
.
J Dent Res
.
2019 Apr
;
98
(
4
):
476
84
.
43.
Wang
K
,
Li
J
.
Overexpression of ANXA3 is an independent prognostic indicator in gastric cancer and its depletion suppresses cell proliferation and tumor growth
.
Oncotarget
.
2016
;
7
(
52
):
86972
84
. .
44.
Ishidou
Y
,
Kitajima
I
,
Obama
H
,
Maruyama
I
,
Murata
F
,
Imamura
T
,
Enhanced expression of type I receptors for bone morphogenetic proteins during bone formation
.
J Bone Miner Res
.
1995 Nov
;
10
(
11
):
1651
9
.
45.
Nakamura
Y
,
Wakitani
S
,
Nakayama
J
,
Wakabayashi
S
,
Horiuchi
H
,
Takaoka
K
.
Temporal and spatial expression profiles of BMP receptors and noggin during BMP-2-induced ectopic bone formation
.
J Bone Miner Res
.
2003 Oct
;
18
(
10
):
1854
62
. .
46.
Kearns
AE
,
Donohue
MM
,
Sanyal
B
,
Demay
MB
.
Cloning and characterization of a novel protein kinase that impairs osteoblast differentiation in vitro
.
J Biol Chem
.
2001 Nov 9
;
276
(
45
):
42213
8
. .
47.
Kanzler
B
,
Foreman
RK
,
Labosky
PA
,
Mallo
M
.
BMP signaling is essential for development of skeletogenic and neurogenic cranial neural crest
.
Development
.
2000 Mar
;
127
(
5
):
1095
104
. .
48.
Li
X
,
Cao
X
.
BMP signaling and skeletogenesis
.
Ann NY Acad Sci
.
2006
;
1068
:
26
40
. .
49.
Rakian
A
,
Yang
WC
,
Gluhak-Heinrich
J
,
Cui
Y
,
Harris
MA
,
Villarreal
D
,
Bone morphogenetic protein-2 gene controls tooth root development in coordination with formation of the periodontium
.
Int J Oral Sci
.
2013
;
5
(
2
):
75
84
.
50.
Lu
Y
,
Qian
Y
,
Zhang
J
,
Gong
M
,
Wang
Y
,
Gu
N
,
Genetic variants of bmp2 and their association with the risk of non-syndromic tooth agenesis
.
PLoS One
.
2016
:
11
(
6
):
e0158273
.
51.
Xu
P
,
Balczerski
B
,
Ciozda
A
,
Louie
K
,
Oralova
V
,
Huysseune
A
,
Fox proteins are modular competency factors for facial cartilage and tooth specification
.
Development
.
2018
;
145
(
12
):
dev165498
.
52.
Laugel-Haushalter
V
,
Paschaki
M
,
Thibault-Carpentier
C
,
Dembelé
D
,
Dollé
P
,
Bloch-Zupan
A
.
Molars and incisors: show your microarray IDs
.
BMC Res Notes
.
2013 Mar 26
;
6
:
113
. .
53.
Rivera-Perez
JA
,
Wakamiya
M
,
Behringer
RR
.
Goosecoid acts cell autonomously in mesenchyme-derived tissues during craniofacial development
.
Development
.
1999 Sep
;
126
(
17
):
3811
21
.
54.
Ganeshkar
SV
,
Rai
AK
,
Rozario
JE
.
The master of craniofacial orchestra: homeobox genes and neural crest cells
.
Intl Arch Integrat Med
.
2015
:
2
(
7
):
162
70
.
55.
Valero
R
,
Bayés
M
,
Francisca Sánchez-Font
M
,
González-Angulo
O
,
Gonzàlez-Duarte
R
,
Marfany
G
.
Characterization of alternatively spliced products and tissue-specific isoforms of USP28 and USP25
.
Genome Biol
.
2001
;
2
(
10
):
RESEARCH0043
. .
56.
Mulvaney
J
,
Dabdoub
A
.
Atoh1, an essential transcription factor in neurogenesis and intestinal and inner ear development: function, regulation, and context dependency
.
J Assoc Res Otolaryngol
.
2012
;
13
(
3
):
281
93
. .
57.
McCright
B
,
Brothman
AR
,
Virshup
DM
.
Assignment of human protein phosphatase 2A regulatory subunit genes b56alpha, b56beta, b56gamma, b56delta, and b56epsilon (PPP2R5A-PPP2R5E), highly expressed in muscle and brain, to chromosome regions 1q41, 11q12, 3p21, 6p21.1
.
Genomics
.
1996 Aug 15
;
36
(
1
):
168
70
.
58.
Morales
CR
,
Grigoryeva
LS
,
Pan
X
,
Bruno
L
,
Hickson
G
,
Ngo
MH
,
Mitochondrial damage and cholesterol storage in human hepatocellular carcinoma cells with silencing of UBIAD1 gene expression
.
Mol Genet Metab Rep
.
2014
;
1
:
407
11
.
59.
Nie
X
,
Zheng
J
,
Ricupero
CL
,
He
L
,
Jiao
K
,
Mao
JJ
.
mTOR acts as a pivotal signaling hub for neural crest cells during craniofacial development
.
PLoS Genet
.
2018 Jul
;
14
(
7
):
e1007491
. .
60.
Zeng
Z
,
Feingold
E
,
Wang
X
,
Weeks
DE
,
Lee
M
,
Cuenco
KT
,
Genome-wide association study of primary dentition pit-and-fissure and smooth surface caries
.
Caries Res
.
2014
;
48
(
4
):
330
8
.
61.
Maes
T
,
Barceló
A
,
Buesa
C
.
Neuron navigator: a human gene family with homology to unc-53, a cell guidance gene from caenorhabditis elegans
.
Genomics
.
2002
;
80
(
1
):
21
30
.
62.
Kim
BJ
,
Kim
AR
,
Han
JH
,
Lee
C
,
Oh
DY
,
Choi
BY
.
Discovery of MYH14 as an important and unique deafness gene causing prelingually severe autosomal dominant nonsyndromic hearing loss
.
J Gene Med
.
2017 Apr
;
19
(
4
):
2950
. .
63.
Paine
I
,
Posey
JE
,
Grochowski
CM
,
Jhangiani
SN
,
Rosenheck
S
,
Kleyner
R
,
Paralog studies augment gene discovery: DDX and DHX genes
.
Am J Hum Genet
.
2019 Aug 1
;
105
(
2
):
302
16
.
64.
Kim
SH
,
Ezhilarasan
R
,
Phillips
E
,
Gallego-Perez
D
,
Sparks
A
,
Taylor
D
,
Serine/threonine kinase MLK4 determines mesenchymal identity in glioma stem cells in an NF-κB-dependent manner
.
Cancer Cell
.
2016 Feb 8
;
29
(
2
):
201
13
.
65.
Lacruz
RS
,
Smith
CE
,
Moffatt
P
,
Chang
EH
,
Bromage
TG
,
Bringas
P
 Jr
,
Requirements for ion and solute transport, and pH regulation during enamel maturation
.
J Cell Physiol
.
2012 Apr
;
227
(
4
):
1776
85
.
66.
Jalali
R
,
Guo
J
,
Zandieh-Doulabi
B
,
Bervoets
TJ
,
Paine
ML
,
Boron
WF
,
NBCe1 (SLC4A4) a potential pH regulator in enamel organ cells during enamel development in the mouse
.
Cell Tissue Res
.
2014 Nov
;
358
(
2
):
433
42
.
67.
Wen
X
,
Kurtz
I
,
Paine
ML
.
Prevention of the disrupted enamel phenotype in Slc4a4-null mice using explant organ culture maintained in a living host kidney capsule
.
PLoS One
.
2014
;
9
(
5
):
e97318
. .
68.
Peng
Z
,
Liu
L
,
Wei
X
,
Ling
J
.
Expression of Oct-4, SOX-2, and MYC in dental papilla cells and dental follicle cells during in-vivo tooth development and in-vitro co-culture
.
Eur J Oral Sci
.
2014 Aug
;
122
(
4
):
251
8
. .
69.
Maas
NM
,
Van de Putte
T
,
Melotte
C
,
Francis
A
,
Schrander-Stumpel
CT
,
Sanlaville
D
,
The C20orf133 gene is disrupted in a patient with Kabuki syndrome
.
J Med Genet
.
2007 Sep
;
44
(
9
):
562
9
.
70.
Opal
S
,
Garg
S
,
Jain
J
,
Walia
I
.
Genetic factors affecting dental caries risk
.
Aust Dent J
.
2015 Mar
;
60
(
1
):
2
11
. .
71.
van der Sluis
S
,
Verhage
M
,
Posthuma
D
,
Dolan
CV
.
Phenotypic complexity, measurement bias, and poor phenotypic resolution contribute to the missing heritability problem in genetic association studies
.
PLoS One
.
2010 Nov 10
;
5
(
11
):
e13929
. .
72.
Kuhnisch
J
,
Thiering
E
,
Heitmuller
D
,
Tiesler
CM
,
Grallert
H
,
Heinrich-Weltzien
R
,
Genome-wide association study (GWAS) for molar-incisor hypomineralization (MIH)
.
Clin Oral Investig
.
2014
;
18
(
2
):
677
82
.
73.
Garg
N
,
Jain
AK
,
Saha
S
,
Singh
J
.
Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management
.
Int J Clin Pediatr Dent
.
2012
;
5
(
3
):
190
6
. .
74.
Xavier
GM
,
Sharpe
PT
,
Cobourne
MT
.
Scube1 is expressed during facial development in the mouse
.
J Exp Zool B Mol Dev Evol
.
2009 Jul 15
;
312B
(
5
):
518
24
. .
75.
Kim
JK
,
Baker
J
,
Nor
JE
,
Hill
EE
.
mTor plays an important role in odontoblast differentiation
.
J Endod
.
2011 Aug
;
37
(
8
):
1081
5
. .
76.
Jeremias
F
,
Koruyucu
M
,
Küchler
EC
,
Bayram
M
,
Tuna
EB
,
Deeley
K
,
Genes expressed in dental enamel development are associated with molar-incisor hypomineralization
.
Arch Oral Biol
.
2013
;
58
(
10
):
1434
42
.
77.
Shaffer
JR
,
Carlson
JC
,
Stanley
BO
,
Feingold
E
,
Cooper
M
,
Vanyukov
MM
,
Effects of enamel matrix genes on dental caries are moderated by fluoride exposures
.
Hum Genet
.
2015 Feb
;
134
(
2
):
159
67
.
78.
Piekoszewska-Zietek
P
,
Turska-Szybka
A
,
Olczak-Kowalczyk
D
.
Single nucleotide polymorphism in the aetiology of caries: systematic literature review
.
Caries Res
.
2017
;
51
(
4
):
425
35
.
79.
Wright
JT
,
Carrion
IA
,
Morris
C
.
The molecular basis of hereditary enamel defects in humans
.
J Dent Res
.
2015 Jan
;
94
(
1
):
52
61
. .
80.
Li
J
,
Ji
L
.
Adjusting multiple testing in multilocus analyses using the eigenvalues of a correlation matrix
.
Heredity
.
2005 Sep
;
95
(
3
):
221
7
. .
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