Epidemiological Profile of Non-Syndromic Tooth Agenesis and Associated Transposition among Iraqi Orthodontic Patients: A Clinic-Based Study

Background: Non-syndromic tooth agenesis and tooth transposition are uncommon anomalies that may arise from similar developmental irregularities during early odontogenesis. The understanding of their occurrence (individually and together) can support diagnosis and strategic clinical management, enhance diagnostic accuracy, and inform treatment planning. Objectives: To assess the prevalence and spatial patterning of permanent tooth agenesis (omitting third molars) among orthodontic patients in Fallujah, Iraq; evaluate variation by sex, arch, and laterality; and document cases in which agenesis occurrence coincides with tooth transposition. Methods: We performed a retrospective, clinic-based cross-sectional study of 1,240 consecutive patients aged 12–43 years who presented for orthodontic assessment or treatment at a private clinic in Fallujah between 2017 and 2024. Records and panoramic radiographs were assessed using consistent operational criteria. Descriptive statistics with 95% confidence intervals were computed; between-group comparisons involved chi-square tests, and an odds ratio was estimated to quantify the sex effect. Results: Tooth agenesis affected 10.48% of patients (95% CI 8.9–12.3); the prevalence was greater in females (11.98%) than in males (6.99%, p