[Difficulties in differential diagnosis of dentin dysplasia. Case report]. / A dentin dysplasia differenciáldiagnosztikai nehézségei. Esetismertetés.

In cases of periapical lesions of unknown origin we have to keep in mind the possibility of dentin dysplasia. From the differential diagnostic point of view of differential diagnosis it is important to recognize this disease as it significantly influences the treatment modality. It is an anomaly of unknown etiology that could affect both deciduous and permanent dentition. Dentin dysplasia presentation varies clinically and radiologically. A rare manifestation which affects 1: 100000 patients is spontaneously occurring either as periapical abscess or odontogenic cyst. The affected teeth could become mobile and eventually lost. Dentin dysplasia is a genetic disease which shows autosomal dominant inheritance and characterized by abnormal formation of dentin structure which occurs during tooth development. For this article we have reviewed available literature and PubMed database. Dentin dysplasia increases the risk of early tooth loss and associated with it esthetic and functional disturbances. As a result it can influence the psychological and social status of the patients and affect their quality of life.

Orthodontic treatment of a patient with dentin dysplasia type I.

Dentin dysplasia is a genetic disorder of the teeth that affects the dentin and the pulp. Type I is sometimes called "rootless teeth," because of the loss of organization of the root dentin, which often leads to a shortened root length. The purpose of this article was to present a rare clinical case of a girl who was diagnosed with dentin dysplasia type I when she was referred for an orthodontic evaluation. Panoramic and periapical radiographs showed defective root formation and areas with periapical radiolucencies in several teeth. Her Angle Class I malocclusion was successfully treated, providing esthetic and functional results, without clinical symptoms or signs of periodontitis or odontogenic infections.

Dentin dysplasia type I with pyogenic granuloma in a 12-year-old girl.

This paper presents a case of dentin dysplasia, a rarely reported disorder that is also associated with pyogenic granuloma in a 12-year-old girl. The case presented as excessively mobile teeth that appeared radiographically as rootless teeth and also as a soft tissue lesion in the right maxillary anterior region.

Dentin dysplasia: single-tooth involvement?

Dentin dysplasia is a genetic defect of dentin formation inherited as an autosomal dominant trait. It is characterized by normal enamel but atypical dentin formation with abnormal pulpal morphology. Once thought to be a single entity, dentin dysplasia has now been divided into type I (radicular) and II (coronal). Type I is by far the more common. Both types include multiple/generalized involvement of primary and permanent dentition. Combinations of both types have also been described in the literature. Four distinct forms of dentin dysplasia type I and 1 form of dentin dysplasia type II are identified. Although there seems to be no need to identify more than 2 distinct types of this relatively rare inherited defect of human dentin, the possible existence of additional forms of the disease cannot be ruled out. Here is a case report of dentin dysplasia in a single tooth, with crown and roots of normal dimensions, associated with severe pain and mobility and histologically involving both coronal and radicular dentin. Focal odontoblastic dysplasia or dentin dysplasia type III could be the new entity.

Cancerización de campo: revisión del concepto / Field cancerization: revision of the concept

El concepto de cancerización de campo sugiere que las mucosas del tracto aerodigestivo superior de un determinado paciente, sometidas de forma similar a los agentes cancerígenos habituales, tienen un mayor riesgo de desarrollar nuevos carcinomas. Desde su acuñamiento, el término se ha empleado para describir múltiples terrenos de enfermedad premaligna, con una prevalencia mayor de la esperada de aparición de múltiples tumores primarios o secundarios locales y la presencia de tumores distantes sincrónicos. Las técnicas moleculares han permitido profundizar en el conocimiento de la relación entre estas lesiones. Si bien hay diferencias metodológicas en la forma de identificar los orígenes clonales de las lesiones, algunos estudios indican que es frecuente la extensión clonal lateral de la enfermedad premaligna o maligna. Ante esta patología, se están investigando diversas alternativas preventivas y terapéuticas, como el screening poblacional, los retinoides o la terapia génica, que pueden aportar beneficios a los pacientes con lesiones premalignas y malignas en la región de cabeza y cuello (AU)

The concept of field cancerization is related to a greater risk of develop one or more carcinomas, on those patients in usual contact with cancerous agents. This term designs several fields of precancerous disease, with more prevalence of multiple primary or secondary local tumours, and distant syncronical tumours as well. Some studies indicate frequent lateral clonal extension of the precancerous and cancerous lesions. The molecular technology has permitted to deep in the knowledge of the relationship between these lesions. In front of this pathology, there are investigated several preventive and therapeutical alternatives, like screening of the population, or administration of retinoids and genic therapy, that can be benefit for these patients (AU)

Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia Type 1.

Dentinal dysplasia (DD) Type I, is a hereditary disturbance in dentine formation. In this anomaly, teeth in both primary and secondary dentitions are affected, and radiographically show short and blunted roots with obliterated root canals and periapical pathosis. Management of patients with DD has presented dentists with problems. Extraction has been suggested as a treatment alternative for teeth with pulp necrosis and periapical abscess. Follow-up and routine conservative treatment is another choice of treatment plan in DD. Another approach for the treatment of teeth with DD has included periapical surgery and retrograde filling, which is recommended in the teeth with long roots. The purpose of this report is to present an unusual case of dentinal dysplasia Type I in a 22-year-old woman showing upper and lower teeth with obliterated root canals and periapical radiolucencies. In this case, conventional endodontic treatment was performed. Postoperative radiographs and clinical evaluation demonstrated periapical healing and successful results. Based on the results of this case report, conventional endodontic treatment for cases with pulp necrosis and periapical radiolucencies in dentinal dysplasia is highly recommended.

Dentin dysplasia type I: report of atypical cases in the permanent and mixed dentitions.

Dentin dysplasia type I is a rare hereditary disturbance of dentin formation characterized clinically by nearly normal appearing crowns and severe hypermobility of teeth. Radiographic analysis shows obliteration of all pulp chambers, short, blunted, and malformed roots, and periapical radiolucencies of noncarious teeth. This paper presents 2 cases demonstrating both classic and atypical features of type I dentin dysplasia in the mixed and permanent dentitions. The clinical, radiographic, and histopathologic\findings of this condition and treatment are described.

Hereditary pattern for dentinal dysplasia type Id: a case report.

Generalized pulpal calcifications arouse suspicion of diseases or conditions of systemic or hereditary origin. This case report describes a 45-year-old patient with generalized pulpal calcifications and bulging of the roots in areas corresponding to the pulp chambers in otherwise normal teeth. Similar findings were present in the patient's daughters and brother. This pattern of pulpal calcifications is consistent with the hereditary condition of dentinal dysplasia type Id.

Localized deficient root development associated with taurodontism: case report.

Dentinal dysplasia type I (DDI) is a rare disturbance in dentin formation. This case report illustrates different radiographic features from other reported DDI cases in that only one quadrant (lower right posterior teeth) has the characteristic of DDI and both right and left upper molars exhibit taurodontism. This finding might be a variation of DDI. However, it is possible that this type of developmental defect could occur because of regionalized abnormalities in cellular function and proliferation as occurs in regional odontodysplasia.

Dentinal dysplasia type I: report of a case.

A case of dentinal dysplasia type I is presented. This rare hereditary disturbance of dentine is characterized by short-rooted teeth with sharp conical apical constrictions, aberrant growth of dentine in the pulp chamber leading to reduced pulp space in permanent teeth and total pulpal obliteration in the primary dentition. Clinical, radiographic and histopathological material from a 7-year-old boy, showing the typical features of this disorder in which teeth are prematurely lost through periapical abscesses, cysts or spontaneous exfoliation, is described. A review of the theories of pathogenesis of this condition is included. Management of patients with dentinal dysplasia is difficult and a discussion of the shortcomings of various treatment strategies, including conventional endodontic therapy, periapical curettage and retrograde root filling, and a preventive regimen, are discussed. In this case, despite diagnosis being made at an early age and the provision of regular dental care, the patient is now losing teeth because of spontaneous abscess formation.

Amelogenesis imperfecta: multiple impactions associated with odontogenic fibromas (WHO) type.

Three types of amelogenesis imperfecta (AI) are recognised, namely hypoplastic, hypomature and hypocalcified varieties. We report on two cases of hypoplastic AI, the type which occurs most frequently. Both patients presented with multiple impacted permanent teeth. Odontogenic fibromas of the WHO type were found to be associated with the crowns of all the impacted teeth and are considered to have prevented normal eruption. Dentinal dysplasia found only in the furcation area of the multirooted impacted teeth was evident. The macroscopic, microscopic and radiological appearance of the affected teeth, pericoronal lesions and interradicular dentinal dysplasia are described, and the most likely origins of the odontogenic fibromas and calcifications observed, are discussed.

Clinical aspects of dental anomalies.

Many inherited disorders have oral manifestations which can be detected on dental radiographs as alterations in the morphology or chemical composition of the teeth. Thus the dentist may be the first to detect disorders of development and metabolism of importance to the general health of the patient and his family. In one group of conditions the pulp chamber is larger than normal. This may be associated with taurodontism in such conditions as polyploidy of the -X chromosome and trisomy-21 or Down's syndrome. Taurodontism also occurs in a variety of other syndromes including the tricho-dento-osseous syndrome described by Robinson, Miller and Worth (1966) and Mohr's syndrome. It may also be associated with scanty hair endoligodentia. In certain metabolic conditions the pulp chamber may be enlarged but the teeth are of relatively normal from (cynodont). Such cases include hypophosphatemic vitamin D-resistant and dependent rickets, pseudo-hypoparthyroidism otodental syndrome and hypophosphatasia. Small pulp chambers and associated anomalies of root morphology also occur in hereditary disorders either alone or as part of various syndromes such as dentino-osseous dysplasia and brackioskeletogenital syndrome. Dentinogenesis imperfecta may occur alone or as one manifestation of osteogenesis imperfecta. Other developmental defects including pulpal dysplasia, labodontia and dens invaginatus are also associated with small pulp chambers.