Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI (2021) – 0.5
Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download original text (EN)

Dental and Medical Problems

2020, vol. 57, nr 2, April-June, p. 207–211

doi: 10.17219/dmp/114248

Publication type: clinical case

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Mirror-image phenomenon in Turkish monozygotic twins: A report of 3 cases

Fenomen lustrzanych odbić u tureckich monozygotycznych bliźniąt – opis trzech przypadków

Damla Torul1,A,B,C,D,E,F, Mehmet Melih Omezli1,A,C,E,F

1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Turkey


Due to the special circumstances and the pre-natal environment in twin gestations, disruptions in the development of the embryo are more frequently observed in twin births as compared to singleton births. Twin research provides an excellent model to explore the etiology of disruptions in craniofacial biology. Mirror imaging (MI) is a special manifestation of twinning, and the elucidation of the etiology of this phenomenon is important to understand the biological mechanisms which underlie congenital defects, like orofacial clefts, and to provide insight into left-right asymmetry. The aim of this paper was, therefore, to present 3 pairs of Turkish monozygotic (MZ) twins with MI dental features, and to contribute to the knowledge of the MI phenomenon in the literature. We examined 2 male and 1 female MZ twin pairs clinically and radiographically in terms of their MI features. Mirrorimage features in dental and other ectodermal structures were detected in all the twins. Understanding the biological mechanisms of MI provides broad insight into preventive measures and treatment protocols. Furthermore, the presence of MI features may lead to the detection of other MI pathologies in twins.

Key words

asymmetry, identical twins, mirror image

Słowa kluczowe

asymetria, bliźnięta identyczne, lustrzane odbicie

References (17)

  1. Hughes TE, Townsend GC, Pinkerton SK, et al. The teeth and faces of twins: Providing insights into dentofacial development and oral health for practising oral health professionals. Aust Dent J. 2014;59(Suppl 1):101–116.
  2. Song J, Song A, Shim A, Kim E, Song M. Mirror-image identical twins presenting in mirror-image hip cysts: A case report and review of the literature. Rheumatol Curr Res. 2013;S17:001.
  3. Sommer IE, Ramsey NF, Bouma A, Kahn RS. Cerebral mirror-imaging in a monozygotic twin. Lancet. 1999;354(9188):1445–1446.
  4. Townsend G, Richards L. Twins and twinning, dentists and dentistry. Aust Dent J. 1990;35(4):317–327.
  5. Townsend GC, Richards L, Hughes T, Pinkerton S, Schwerdt W. The value of twins in dental research. Aust Dent J. 2003;48(2):82–88.
  6. Zhou JY, Pu JL, Chen S, Hong Y, Ling CH, Zhang JM. Mirror-image arachnoid cysts in a pair of monozygotic twins: A case report and review of the literature. Int J Med Sci. 2011;8(5):402–405.
  7. Satoh K, Shibata Y, Tokushige H, Onizuka T. A mirror image of the first and second branchial arch syndrome associated with cleft lip and palate in monozygotic twins. Br J Plast Surg. 1995;48(8):601–605.
  8. Brent B. Repair of microtia with sculpted rib cartilage grafts in identical, mirror-image twins: A case study. Ann Plast Surg. 2011;66(1):62–64.
  9. Sperber GH, Machin GA, Bamforth FJ. Mirror-image dental fusion and discordance in monozygotic twins. Am J Med Genet. 1994;51(1):41–45.
  10. Beere D, Hargreaves JA, Sperber GH, Cleaton-Jones P. Mirror image supplemental primary incisor teeth in twins: Case report and review. Pediatr Dent. 1990;12(6):390–392.
  11. Kaprio J, Sarna S, Koskenvuo M, Rantasalo I. The Finnish Twin Registry: formation and compilation, questionnaire study, zygosity determination procedures, and research program. Prog Clin Biol Res. 1978;24(Pt B):179–184.
  12. Bishop DVM. Handedness and specific language impairment: A study of 6-year-old twins. Dev Psychobiol. 2005;46(4):362–369.
  13. Golbin A, Golbin Y, Keith L, Keith D. Mirror imaging in twins: Biolo­gical polarization – an evolving hypothesis. Acta Genet Med Gemellol (Roma). 1993;42(3–4):237–243.
  14. Sommer IE, Ramsey NF, Mandl RC, Kahn RS. Language lateralization in monozygotic twin pairs concordant and discordant for handedness. Brain. 2002;125(Pt 12):2710–2718.
  15. Badzakova-Trajkov G, Häberling IS, Corballis MC. Cerebral asymmetries in monozygotic twins: An fMRI study. Neuropsychologia. 2010;48(10):3086–3093.
  16. Thacker D, Gruber PJ, Weinberg PM, Cohen MS. Heterotaxy syndrome with mirror image anomalies in identical twins. Congenit Heart Dis. 2009;4(1):50–53.
  17. Lohr JB, Bracha HS. A monozygotic mirror-image twin pair with discordant psychiatric illnesses: A neuropsychiatric and neurodeve­lopmental evaluation. Am J Psychiatry. 1992;149(8):1091–1095.