Histopathological Features Of Shell Teeth

Histopathological Features Of Shell Teeth

Question. Write a short note on dentinogenesis imperfecta.

Answer. Dentinogenesis imperfecta is an inherited disorder of dentin formation that affects deciduous and permanent dentition.

Classifiation

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Sheild’s Classification

• Dentinogenesis imperfecta Type I: Dentinogenesis imperfecta without osteogenesis imperfecta.
• Dentinogenesis imperfecta Type II: Dentinogenesis imperfecta with osteogenesis imperfect
• Dentinogenesis imperfecta Type III: It is a racial isolate in Maryland and is known as Brandywine type.

Extensive studies have shown that dentinogenesis imperfect is a disorder from osteogenesis imperfect, so the following revised classification is given:

• Dentinogenesis imperfecta1: Dentinogenesis imperfect a without osteogenesis imperfecta (opalescent dentine). This corresponds to dentinogenesis imperfect
  Type II of Sheild’s classification.
• Dentinogenesis imperfect 2: Brandywine type dentinogenesis imperfect: This corresponds to dentinogenesis imperfect Type II of Sheild’s Classification.

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There is no substitute in present classification for the category which is designated as Dentinogenesis imperfect Type I of Sheild’s classification.

Etiology

Gene affected is present on chromosome 4 and it codes for DSPP (Dentine sialoprotein and phosphoprotein)

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Clinical Features

• On eruption, the teeth exhibit a normal contour and have an opalescent amber-like appearance.
• A few days after the eruption, the teeth may achieve the normal color. Finally, the teeth become gray or brownish with a bluish reflection from the enamel.
• In some cases, the affected teeth may exhibit hypomineralized areas on the surface of the enamel.
• Teeth are not particularly sensitive even when most of the surface enamel is lost.
• The dentin is soft and easily penetrable in dentinogenesis imperfecta; these teeth are not caries-prone.

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Histopathology

• Histopathologically, the enamel appears normal in Dentinogenesis imperfecta. Mantle dentin is also nearly normal.
• Dentinal tubules are fewer in number per square unit area of dentin as compared to normal dentin. The tubules are often distorted, irregular in shape, widely spaced, and larger.
• Pulp chamber and root canal are often obliterated by the abnormal dentin deposition.
• DEJ appears smooth or flattened instead of being scalloped.
• A large area of tubular dentin is present.

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