X-ray microanalysis of dentine in primary teeth diagnosed Dentinogenesis Imperfecta type II

Progress in the pathogenic mechanism, histological characteristics of hereditary dentine disorders and clinical management strategies

Hereditary dentine disorders are autosomal dominant diseases that affect the development and structure of dentine, leading to various dental abnormalities and influencing the individual's oral health. It is generally classified as dentinogenesis imperfecta (DGI) and dentine dysplasia (DD). Specifically, DGI is characterized by the abnormal formation of dentine, resulting in teeth that are discolored, translucent, and prone to fracture or wear down easily. DD is characterized by abnormal dentine development, manifested as teeth with short roots and abnormal pulp chambers, leading to frequent tooth loss. Up to now, the pathogenesis of hereditary dentine disorders has been poorly clarified and the clinical intervention is limited. Treatment for hereditary dentine disorders focuses on managing the symptoms and preventing further dental problems. Genetic counseling and testing may also be recommended as these conditions can be passed on to future generations. In this review, we summarize the clinical features, pathogenic genes, histomorphological characteristics and therapy of hereditary dentine disorders. Due to the limited understanding of the disease at present, we hope this review could improve the recognition of the disease by clinicians, stimulate more scholars to further study the deeply detailed mechanisms of the disease and explore potential therapeutic strategies, thus achieving effective, systematic management of the disease and improving the life quality of patients.

Identification of DSPP novel variants and phenotype analysis in dentinogenesis dysplasia Shields type II patients

OBJECTIVES

To investigate the genetic causes and teeth characteristics of dentin dysplasia Shields type II(DD-II) in three Chinese families.

MATERIALS AND METHODS

Data from three Chinese families affected with DD-II were collected. Whole-exome sequencing (WES) and whole-genome sequencing (WGS) were conducted to screen for variations, and Sanger sequencing was used to verify mutation sites. The physical and chemical characteristics of the affected teeth including tooth structure, hardness, mineral content, and ultrastructure were investigated.

RESULTS

A novel frameshift deletion mutation c.1871_1874del(p.Ser624fs) in DSPP was found in families A and B, while no pathogenic mutation was found in family C. The affected teeth's pulp cavities were obliterated, and the root canals were smaller than normal teeth and irregularly distributed comprising a network. The patients' teeth also had reduced dentin hardness and highly irregular dentinal tubules. The Mg content of the teeth was significantly lower than that of the controls, but the Na content was obviously higher than that of the controls.

CONCLUSIONS

A novel frameshift deletion mutation, c.1871_1874del (p.Ser624fs), in the DPP region of the DSPP gene causes DD-II. The DD-II teeth demonstrated compromised mechanical properties and changed ultrastructure, suggesting an impaired function of DPP. Our findings expand the mutational spectrum of the DSPP gene and strengthen the understanding of clinical phenotypes related to the frameshift deletion in the DPP region of the DSPP gene.

CLINICAL RELEVANCE

A DSPP mutation can alter the characteristics of the affected teeth, including tooth structure, hardness, mineral content, and ultrastructure.

Phenotype and molecular characterizations of a family with dentinogenesis imperfecta shields type II with a novel DSPP mutation

Background

Dentinogenesis imperfecta (DGI), Shields type-II is an autosomal dominant genetic disease which severely affects the function of the patients’ teeth. The dentin sialophosphoprotein (DSPP) gene is considered to be the pathogenic gene of DGI-II. In this study, a DGI-II family with a novel DSPP mutation were collected, functional characteristics of DGI cells and clinical features were analyzed to better understand the genotype-phenotype relationship of this disease.

Methods

Clinical data were collected, whole exome sequencing (WES) was conducted, and Sanger sequencing was used to verify the mutation sites. Physical characteristics of the patient’s teeth were examined using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The localization of green fluorescent protein (GFP)-fused wild-type (WT) dentin sialoprotein (DSP) and its variant were evaluated via an immunocytochemistry (ICC) assay. The behaviors of human dental pulp stem cells (hDPSCs) were investigated by flow cytometry, osteogenic differentiation, and quantitative real-time polymerase chain reaction (qRT-PCR).

Results

A novel heterozygous mutation c.53T > G (p. Val18Gly) in DSPP was found in this family. The SEM results showed that the participants’ teeth had reduced and irregular dentinal tubes. The EDS results showed that the Ca/P ratio of the patients’ teeth was significantly higher than that of the control group. The ICC assay showed that the mutant DSP was entrapped in the endoplasmic reticulum (ER), while the WT DSP located mainly in the Golgi apparatus. In comparison with normal cells, the patient’s cells exhibited significantly decreased mineralization ability and lower expression levels of DSPP and RUNX2.

Conclusions

The c.53T > G (p. Val18Gly) DSPP variant was shown to present with rare hypoplastic enamel defects. Functional analysis revealed that this novel variant disturbs dentinal characteristics and pulp cell behavior.

Physicochemical properties of dentinogenesis imperfecta with a known DSPP mutation

AIM

To investigate the chemical and mechanical properties of teeth affected by a 1-bp deletion (c.2688delT) in the DSPP gene.

METHODS AND MATERIALS

Maxillary first premolars were extracted from the affected individual at age 9 years due to the orthodontic reason for crowding. A sample was imbedded in epoxy resin and sectioned buccolingually, after micro-computerized tomography (μCT) images were taken. Scanning Electron Microscopy (SEM), Energy Dispersive Spectrometry (EDS) and Vickers microhardness testing were also performed.

RESULTS

μCT reconstruction and analysis showed an irregularly obliterated pulp chamber and an extremely small pulpal volume in the DGI-II sample. The mineral density and microhardness scores were smaller in the dentin of the DGI-II sample compared to the wild-type. Mg content was lower in the dentin of the DGI-II sample compared to the wild-type.

CONCLUSION

This study shows that dentin affected by a 1-bp deletion in DSPP has a reduced mineral density, diminished microhardness and reduced Mg content.