Signs and Symptoms
- Misalignment of neighboring teeth and overcrowding
- Malocclusion resulting in severe jaw joint pain
- Cavities development due to irregular tooth shape
- Significant self-esteem and confidence issues related to physical appearance

Causes
- Associated with genetic syndromes such as otodental syndrome, insulin-resistant diabetes, facial hemihyperplasia, KGB syndrome, and 47 XYY syndrome
- Genetic mutations regulating tooth growth can cause abnormal growth
- Hormonal imbalances, likely related to the pituitary gland, can result in deviant tooth growth
- Factors during early childhood, such as diet and exposure to toxins or radiation, can increase the likelihood of macrodontia

Pathophysiology
- Gigantism, caused by excessive growth hormone secretion, can lead to macrodontia
- Growth hormone stimulates the synthesis of insulin-like growth factor 1 (IGF-1) which controls body growth
- Mutant form of the Gs protein in growth hormone-secreting adenomas results in overexpression of growth hormone and overgrowth of teeth
- KBG syndrome, caused by a mutation in the ANKRD11 gene, leads to macrodontia due to abnormal regulation of dental development

Diagnosis
- Diagnosis is obtained through observation, measurement, and comparison with standard tooth size
- Radiological investigation, such as X-rays, can indicate macrodontia of erupted and unerupted teeth
- Level 1 radiographic examination should consider medical records, clinical signs, and risk/benefits of radiation exposure
- Orthopantomography and intraoral radiography may be recommended as imaging techniques
- CBCT (3D imaging) is used when two-dimensional imaging is insufficient

Types of Macrodontia
- True generalised macrodontia is when all teeth grow larger than normal, often associated with pituitary gigantism
- Localised macrodontia affects specific teeth or tooth groups
- Fusion macrodontia occurs when two teeth fuse together, resulting in an enlarged tooth
- Gemination macrodontia is when a single tooth appears as two separate teeth due to incomplete tooth division
- Dilaceration macrodontia is characterised by abnormal tooth curvature or angulation

Treatment:
- Diagnosis by a dental specialist
- Recommendation to visit a cosmetic dentist
- Three main procedures for improving the look of affected teeth: orthodontics, teeth shaving, and teeth removal
- Orthodontics can straighten teeth and expand the jaw if necessary
- Braces and a retainer can help minimize misalignment caused by macrodontia

Prognosis:
- Macrodontia does not affect life expectancy or likelihood of remission
- Implications include misalignment, jaw pain, and crowding issues
- Complications of untreated macrodontia include bite alignment issues and dental caries
- Overgrown teeth can have lasting impacts on bite mechanics
- Dental caries can lead to tooth degradation and infections

Epidemiology:
- Macrodontia affects 0.03% of the population
- Higher prevalence in males (1.2%) compared to females (0.9%)
- Disruptions of regular tooth growth usually occur around ages 11-12

Research Direction:
- Lack of understanding regarding pathophysiological mechanisms of macrodontia
- Imaging techniques used for diagnosis
- Treatment options concentrated in cosmetic dentistry
- Correlation between genetic mutations and macrodontia
- No current clinical trials for treatment