Nutritional And Environmental Factors In Enamel Hypoplasia

Nutritional And Environmental Factors In Enamel Hypoplasia

Question 1. Enumerate causes of enamel hypoplasia and describe amelogenesis imperfecta in detail.

Answer.

Enumeration Of Causes Of Enamel Hypoplasia

Following are the causes of enamel hypoplasia:

• Nutritional defiiency (Vitamins A, C and D)
• Exanthematous diseases, i.e. measles, chicken pox and scarlet fever
• Congenital syphilis
• Hypocalcemia
• Birth injury, prematurity, Rh hemolytic disease
• Local infection or trauma
• Ingestion of chemicals such as floride
• Idiopathic causes

“Role of nutrition in enamel hypoplasia development”

Question 2. Write short note on Melkersson–Rosenthal syndrome.

Answer. This syndrome is the triad of chelitis granulomatosa,fisured tongue, facial palsy.

• Melkersson–Rosenthal syndrome is occasionally a manifestation of Crohn disease or orofacial granulomatosis.
• A genetic predisposition may exist in Melkersson–
  Rosenthal syndrome.
• Histologically the swellings of syndrome consist of chronic inflmmatory cell infitration which shows peri and para vascular aggregation of lymphocytes,plasma cells and histiocytes.
  At places non­caseating granuloma formation is seen along with epithelioid cells and LanghAns type giant cells.
• Six pattrns of fisured tongue are associated with the Melkersson, Rosenthal syndrome, i.e. central longitudinal fisuring, transverse fisuring originating from central fisure, plication, lateral longitudinal fisuring, transverse fisuring with central fisure and lateral longitudinal fisuring.

“Environmental causes of enamel hypoplasia”

Question 3. Write short note on talon’s cusp.

Answer. Talon’s cusp is a well delineated accessory cusp which resembles as eagle’s talon which project lingually from cingulum areas of maxillary or mandibular permanent incisor.

• Talon’s cusp consists of normal enamel and dentin and has a horn of pulp tissue.
• Talon’s cusp blends smoothly with the tooth except that there is deep developmental groove where the cusp blends with sloping lingual tooth surface.
• Due to presence of Talon’s cusp patient’s face the problem with esthetics. There is also presence of occlusal interference and high incidence of caries is also noticed.
• Talon’s cusp is associated with Rubinstein Taybi’s syndrome as well as Sturge-Weber syndrome.

“Vitamin D and enamel hypoplasia connection explained”

Question 4. Write short note on facial hemiatrophy.

Answer. It is also known as Parry Romberg syndrome.
It is the slowly progressive atrophy of soft tissue mainly half of the face and is also characterized by wasting of subcutaneous fat which sometimes accompanied by atrophy of skin, cartilage,bone and muscle.

Clinical Features

• It occurs during fist and second decades of life.
• Females are more commonly affcted as compared to males.
• It occurs more commonly over the left side of face.
• Onset of facial hemiatrophy is marked by white line furrow.
• Earliest sign is the presence of painless cleft.
• Patients can show sharp line of demarcation which resemble as large scar in between normal and abnormal skin.
• This is known as Coup de sabre.
• Overlying the atrophic fat, a bluish hue may appear on the skin.

“Impact of malnutrition on tooth enamel formation”

Oral Manifestations

• Presence of severe facial hemiatrophy, which leads to facial deformation and mastication.
• Presence of hemiatrophy of lips and tongue.
• Delayed eruption is present which leads to malocclusion.
• Presence of incomplete root formation.
• During opening the mouth jaw is deviated towards affected side.

Differential Diagnosis

• Post traumatic atrophy: Brief history from patient is important.
• Goldenhar syndrome: It is non­progressive and is congenital.
  Mandibulofacial dysostosis: It is hereditary and cleft palate is present.

“Infections during pregnancy and enamel hypoplasia”

Treatment

• Surgical reconstruction is done.
• Malocclusion should be corrected by orthodontic treatment.