Aim: The aim of this study was to examine tooth length and root canal anatomy of 281 anterior and premolar teeth from 66 DS individuals using a standard protocol.

Results: The results indicated that root canals in DS are relatively simple and that there is a significant reduction in root and crown length.

Conclusions: We propose that these observations are commensurate with the suggestion that trisomy 21 exerts its effect by slowing the mitotic cycle and rate of cell proliferation, resulting in generalized retardation of growth.