Associations between 44 nonmetric permanent dental traits or anomalies with skeletal sagittal malocclusions and sex, besides correlations across the variations or abnormalities

INTRODUCTION: Nonmetric dental traits and the shape, size, or number of dental anomalies are essential to various dental fields such as orthodontics, dental anatomy, anthropology, pathology, and forensic dentistry. Nonetheless, many are not well assessed worldwide. Moreover, most studies are limited to a few nonmetric traits. Therefore, we aimed to examine several nonmetric dental traits/anomalies. METHODS: In this cross-sectional epidemiological study, ~ 9000 permanent teeth of 331 non-syndromic orthodontic patients (radiographs and dental casts) with fully erupted permanent dentitions (except the third molars and some cases of a few teeth missing or excluded) were evaluated by two observers, each twice, in search for 62 nonmetric traits/shape-number-size anomalies. The traits/anomalies of interest were supernumerary, microdontia, peg-shaped lateral, shovelings, talon cusps, Carabelli cusps, fifth/sixth/seventh cusps on the molars, hypocone/hypoconulid absence, protostylid, deflecting wrinkle‏s, canine mesial ridge, distal trigonid crest, canine distal accessory ridge, accessory cusps in the mesial/distal marginal ridges, mesial/distal accessory ridges, and accessory cusps in the lingual of the mandibular premolars and second molars). Data, at both patient/quarter levels, were analyzed regarding the associated factors (skeletal Angle classes, crowding, sex, and sides) as well as the correlations among traits, using the chi-square test and Spearman correlation coefficient (α = 0.05). RESULTS: Prevalence rates of 44 traits/anomalies were reported (18 out of the 62 searched traits/anomalies were not found [prevalence = 0%]). Microdontia and accessory cusps on the marginal ridge of the second mandibular molars were significantly more common in women (P < 0.05). Canine talon cusp and distal trigonid crest of the second mandibular molars were more prevalent in men (P < 0.05). Shoveling, canine talon cusp, canine distal accessory ridge, and accessory cusp in the first premolar might be more prevalent in skeletal Angle class II; whereas, accessory cusp in the mesial marginal ridge of the second premolar might be rather more prevalent in skeletal Angle class I (P < 0.05). Few dental traits were positively and moderately or strongly correlated with each other (Spearman Rho ≥ 0.4, P < 0.0005). CONCLUSIONS: Sex dimorphism was uncommon in nonmetric dental traits/anomalies. Skeletal malocclusions may be associated with a few dental abnormalities or variations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-022-02481-y.