alt="Photo depicts H and E stained decalcified section showing DD with the typical water around the boulders appearance."/>
Figure 1.16 H and E stained decalcified section showing DD with the typical “water around the boulders” appearance.
1.8.1 Description
Dentin dysplasia (DD) is a rare genetic disorder that affects the development of dentin, mostly in radicular area. It can affect both dentitions, where the teeth have normal enamel but abnormal dentin with atypical pulp morphology. The first classification of DD was put forward by Witkop in the 1970s with DD divided into two types: DD‐1 (radicular type) and DD‐2 (coronal type) [16]. The teeth affected by DD‐1 present with short, blunt roots with obliterated pulp chambers. In DD‐2, teeth present with discoloration (brown to blue, amber colored, or opalescent), normal roots but enlarged pulp chambers (thistle tube appearance). The pulp chambers of primary teeth in DD‐2 are almost completely obliterated whereas in permanent teeth, they may be partially obliterated.
1.8.2 Key Identifying Features
Histologically, irregular dentin with a disturbed tubular pattern, atubular areas, and globular atypical dentin masses inside pulp chambers can be seen.
1.8.3 Clinical Considerations
The etiology of this disease is still unclear. Wesley et al. previously proposed that it could be due to a problem with ameloblasts which leads to an abnormal differentiation of odontoblasts, leading to DD [17]. It was also proposed earlier that due to a problem with dental papilla (foci within it becoming calcified), DD develops as a result of less growth and/or obliteration of pulp chambers [18]. The diagnosis is based on clinical examination and radiographs. The teeth affected by DD have esthetic and functional abnormalities [19]. In addition, they are more prone to be mobile and are exfoliated prematurely [19]. The treatment options include stainless‐steel crowns, endodontic therapy (although difficult due to obliteration of pulp chambers), removable dentures, and dental implants [20–22].
References
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11 11 Chen, C.F., Hu, J.C., Bresciani, E. et al. (2013). Treatment considerations for patient with amelogenesis imperfecta: a review. Braz Dent Sci 16 (4): 7–18.
12 12 Barron, M.J., McDonnell, S.T., Mackie, I., and Dixon, M.J. (2008). Hereditary dentine disorders: dentinogenesis imperfecta and dentine dysplasia. Orphanet J Rare Dis 3: 31.
13 13 Gama, F.J.R., Corrêa, I.S., Valerio, C.S. et al. (2017). Dentinogenesis imperfecta type II: a case report with 17 years of follow‐up. Imaging Sci Dent 47 (2): 129–133.
14 14 Sapir, S. and Shapira, J. (2001). Dentinogenesis imperfecta: an early treatment strategy. Pediatr Dent 23 (3): 232–237.
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17 17 Wesley, R.K., Wysoki, G.P., Mintz, S.M., and Jackson, J. (1976). Dentin dysplasia type I. Clinical, morphologic, and genetic studies of a case. Oral Surg Oral Med Oral Pathol 41 (4): 516–524.
18 18 Logan, J., Becks, H., Silverman, S. Jr., and Pindborg, J.J. (1962). Dentin dysplasia. Oral Surg 15: 317.
19 19 Komlós, G., Joób‐Fancsaly, Á., Pataky, L. et al. (2015). Difficulties in differential diagnosis of dentin dysplasia. Case report. Fogorv Sz 108 (2): 53–56.
20 20 Byahatti, S.M. (2013). Dentin dysplasia type I: a rare case report. Int J Oral Health Sci 3: 57–60.
21 21 Ravanshad, S. and Khayat, A. (2006). Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia type 1. Aust Endod J 32 (1): 40–42.
22 22 Muñoz‐Guerra, M.F., Naval‐Gías, L., Escorial, V., and Sastre‐Pérez, J. (2006). Dentin dysplasia type I treated with onlay bone grafting, sinus augmentation, and osseointegrated implants. Implant Dent 15 (3): 248–253.
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