Developmental Disturbances Of Teeth

Developmental Disturbances Of Teeth

Question. Enumerate the developmental disturbances affecting the structures of teeth and discuss in detail amelogenesis imperfecta.
Or
Enumerate developmental disturbances affecting the structures of teeth. Write in detail about amelogenesis imperfecta.

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Answer.

Enumeration Of Developmental Disturbances Affecting the Structure Of Teeth

• Amelogenesis imperfecta
• Dentinogenesis imperfecta
• Enamel hypoplasia
• Dentin dysplasia
• Regional odontodysplasia
• Dentin hypocalcification

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Amelogenesis Imperfecta

Amelogenesis imperfecta is a group of hereditary disorders characterized by alteration of the quantity and quality of enamel in humAns and is frequently associated with a signifiant dental disease. Witkop and Sauk (1976)

Classification of Amelogenesis Imperfecta

Witkop, 1988 Four major categories based primarily on phenotype (hypoplastic, hypomaturation, hypocalcified,hypomaturation­hypoplastic with taurodontism) subdivided into 15 subtypes by phenotype and secondarily by mode of inheritance.

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• Type I–Hypoplastic
• Type IA–Hypoplastic, pittd autosomal dominant
• Type IB–Hypoplastic, local autosomal dominant
• Type IC–Hypoplastic, local autosomal recessive
• Type ID–Hypoplastic, smooth autosomal dominant
• Type IE–Hypoplastic, smooth X­linked dominant
• Type IF–Hypoplastic, rough autosomal dominant
• Type IG–Enamel agenesis, autosomal recessive
• Type II–Hypomaturation
• Type IIA–Hypomaturation, pigmented autosomal recessive

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• Type IIB–Hypomaturation, X­linked recessive
• Type IIC–Hypomaturation, snow­capped teeth, X­linked
• Type IID–Hypomaturation, snow­capped teeth, autosomal dominant?
• Type IIIA–Autosomal dominant
• Type IIIB–Autosomal recessive
• Type IV–Hypomaturation­hypoplastic with taurodontism
• Type IVA–Hypomaturation­hypoplastic with taurodontism, autosomal dominant
• Type IVB–Hypoplastic­hypomaturation with taurodontism, autosomal dominant

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Histopathology

• There is a disturbance in the diffrentiation or viability of ameloblasts in the hypoplastic type, and this is reflcted in defect in matrix formation up to and including total absence of matrix.
• In the hypocalcifiation type there are defects of matrix structure and of mineral deposition.
• In the hypomaturation type there are alterations in enamel rod and rod sheath structures.
• Ground section of the teeth involved showed very thin enamel, composed of laminations of irregularly arranged enamel prisms.

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Radiographic Features

• The enamel may appear totally absent on the radiograph,or when present may appear as a very thin layer chiefl over the tips of cusps and on the inter­proximal surfaces.
• In other cases the calcifiation of the enamel may be so affcted that it appears to have the same approximate radiodensity as the dentin, making diffrentiation, between the two diffilt.

Treatment

• There is no defiite treatment of amelogenesis imperfecta.
• Composite veneering can be done to improve esthetics of teeth.