Dental abnormalities in individuals with pathogenic germline variation in DICER1

Am J Med Genet A. 2019 Sep;179(9):1820-1825. doi: 10.1002/ajmg.a.61292. Epub 2019 Jul 16.


Pathogenic germline variation in the microRNA processing gene DICER1 gives rise to an autosomal dominant, tumor-predisposition disorder. Conditional deletion of Dicer1 in murine dental epithelium shows that it controls tooth patterning, size, number, and shape. The human dental phenotype of people with germline pathogenic variation in DICER1 is unknown. DICER1-carriers (n = 57) and family controls (n = 55) were evaluated at the NIH Clinical Center dental clinic as part of a comprehensive medical evaluation. Digital panoramic radiographs, bite-wing radiographs, and oral photographs were collected. A single observer, blind to DICER1 status, reviewed the dental records and determined the presence or absence of 11 dental characteristics as described in the clinic notes, radiographs, or oral photographs. Subjective phenotypes were reviewed on radiographs by two examiners (blind to DICER1 status) for the presence or absence of the dental characteristics to reduce inconsistencies. By simple association, bulbous crown, periodontitis, and taurodontism were all significant (p < .05). Logistic regression with chi-square maximum likelihood estimates showed that bulbous crown and periodontitis remained significant. Recognition of these phenotypes may aid identification of individuals and families at risk for DICER1-associated neoplasms. These findings may also guide dental care for individuals with germline DICER1 pathogenic variation.

Keywords: DICER1; bulbous crowns; periodontal disease; syndromes; taurodontism; tooth morphology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • DEAD-box RNA Helicases / genetics*
  • Dental Pulp Cavity / abnormalities*
  • Dental Pulp Cavity / diagnostic imaging
  • Dental Pulp Cavity / physiopathology
  • Female
  • Germ-Line Mutation / genetics
  • Humans
  • Male
  • Middle Aged
  • Periodontal Diseases / diagnostic imaging
  • Periodontal Diseases / genetics*
  • Periodontal Diseases / physiopathology
  • Radiography, Panoramic
  • Ribonuclease III / genetics*
  • Tooth Abnormalities / diagnostic imaging
  • Tooth Abnormalities / genetics*
  • Tooth Abnormalities / physiopathology
  • Young Adult


  • DICER1 protein, human
  • Ribonuclease III
  • DEAD-box RNA Helicases

Supplementary concepts

  • Taurodontism