Endodontic treatment of dentin dysplasia type I D

Dentin dysplasia (DD) Type I is a developmental condition affecting dentin, inherited in an autosomal-dominant pattern or occurring due to a new mutation. Whilst the crowns of DD Type I affected teeth appear clinically normal, the roots are blunt and shortened. Pulp necrosis and periapical pathoses may be seen in the absence of obvious causes. Pulp stones and calcifications are frequently encountered. Endodontic management of DD may be challenging. A case of DD Type I, sub-classification d, in which spontaneous irreversible pulpitis developed on three mandibular incisors is documented. The case was managed by conventional endodontic treatment. Knowledge of this uncommon dental condition may assist dentists to adequately diagnose and manage these cases. Extraction should not be considered the first-line treatment option when sufficient root length is available to attempt endodontic treatment. Referral for medical evaluation is recommended to rule out systemic diseases which may mimic this condition.

[Difficulties in differential diagnosis of dentin dysplasia. Case report]

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.

Florid cemento-osseous dysplasia mimicking multiple periapical pathology--an endodontic dilemma

A case of florid cemento-osseous dysplasia (COD) mimicking periapical pathology is presented. The fact that the patient's lesion failed to resolve three years after root canal therapy, in addition to the presence of a mixed radiolucency with discreet radiopacities, mandated a biopsy which (along with radiographic co-relation) confirmed the diagnosis of cemento-osseous dysplasia. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment.

Dentin dysplasia type I treated with onlay bone grafting, sinus augmentation, and osseointegrated implants

Dentin dysplasia is a defect of dentin development that was classified by Shields as type I and type II. The teeth in dentin dysplasia type I are characterized by normal enamel and abnormal dentin in the crown and root. For that reason, this disorder is characterized by dental caries, early exfoliation of the teeth and, consequently, maxillomandibular bony atrophy. In this report, we present a case of a young girl affected by dentin dysplasia type I, treated with a combination of onlay bone grafting and a sinus lift technique to accomplish implant placement. This case showed that onlay autogenous grafting and a sinus lift technique are well-tested methods of bony augmentation and can be useful in patients with congenital dentin defects, such as dentin dysplasia.

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.

Assessment of dysplastic dentin in osteogenesis imperfecta and dentinogenesis imperfecta

Two semiquantitative scoring systems, Clinical Radiographic Score (CRS) and Dysplastic Dentin Score (DDS), were introduced for analyzing degree of dysplastic manifestations in dentin. The utility of both systems was demonstrated in a large material of teeth from patients with dentinogenesis imperfecta (DI) and osteogenesis imperfecta (OI). Twenty teeth from healthy controls, 81 teeth from 40 patients with OI, and 18 teeth with DI without OI (DI type II) were examined. The degree of dysplasia was correlated with type and form of OI and type of DI. The median DDS did not differ between DI associated with OI (DI type I) and DI type II. DDS in OI patients without clinical signs of DI was above that of control teeth. Both circumpulpal and mantle dentin showed increased DDS, although circumpulpal dentin was more severely affected. The median DDS was highest for the most severe type of non-lethal OI (type III). DDS increased significantly with form (severity) of OI. A significant association between DDS and CRS was found, although diagnosis of DI in less severe cases was not possible based on radiographic or clinical signs alone. Thus, the DDS system proved valuable when the CRS system based on radiographic/clinical manifestations failed, the most significant finding being subclinical histological manifestations of DI in patients with OI but without clinical or radiographic signs of DI. These subtle dysplastic changes are most likely an expression of genetic disturbances associated with OI and should not be diagnosed as DI, but rather be termed histologic manifestations of dysplastic dentin associated with OI.

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.

Dentin dysplasia type I--a case report

A case report on dentin dysplasia type I, a congenital disease (autosomal dominant gene defect) affecting deciduous and permanent teeth, is depicted including representations of clinical and histological features, X-ray and CT-findings. Therapy includes extraction of all teeth, ectomization of cystic alteration, revision of paranasal sinus. Aesthetic and functional rehabilitation by means of insertion of a complete denture was achieved.

Dentin dysplasia type I. Report of case and ultrastructural study

Radicular dentin dysplasia (DD-I) is a rare hereditary dental alteration. It is characterized clinically by almost normal looking crowns and severe hypermobility of the teeth. The radiographic analysis, on the other hand, discloses the obliteration of all pulp chambers, the short, malformed roots and plenty of periapical bone radiolucencies on noncarious teeth. A case of radicular dentin dysplasia is presented. In this 43-year-old woman the diagnosis was supported, besides the clinical and radiographic analysis, by the pedigree of the proband, which showed the autosomal dominant pattern of feature transmission. Further-more, the electron microscopic analysis of one extracted molar revealed the atubular structure of the secondary dentin, and its globular organization.

Dentin dysplasia type I: five cases within one family

Five cases of dentin dysplasia type I within one family are described. Clinically and radiologically, such patients are characterized by a delayed eruption pattern, opacity of the incisional margins, hypermobility of the teeth, short and defective roots, and obliterated pulp chambers. A conservative attitude toward the treatment of common conditions in dentin dysplasia type I favors the preservation of a vulnerable dentition.

Dentin dysplasia type I. Radiologic and genetic perspectives in a six-generation family

This is a report of a kindred of at least 181 members, of whom 35 exhibit or are reported to have dentin dysplasia type I. Six others are suspected of having the condition. Radiographic evidence that included obliterated or semilunar pulp chambers and short or undeveloped roots confirmed the diagnosis in 18 persons. The autosomal dominant mode of inheritance has been confirmed. One hundred percent penetrance has been demonstrated. There were insufficient data to determine the degree of expressivity.

Dentin dysplasia: review of the literature and a proposed subclassification based on radiographic findings

The literature is reviewed to determine the radiographic appearance of the reported cases of dentin dysplasia. The sometimes confusing nomenclature is rationalized. Four distinct forms of dentin dysplasia type I and one form of dentin dysplasia type II are identified. There seems to be no need to identify more than two distinct types of this relatively rare inherited defect of human dentin, but a proposed subclassification of type I dentin dysplasia could make identification of the two types easier.

Clinical, radiographic, and histological manifestations of dentin dysplasia, type I: Report of case

Dentin dysplasia, type I, is a rare dental anomaly characterized by abnormal dentin formation affecting the roots of both primary and permanent teeth. Short, conical roots with occlusion of the pulp chamber and canal are produced. Periapical radiolucent areas are common, although no evidence of caries or trauma to the tooth may be seen. Coronal mantle dentin is unaffected, resulting in an apparently normal clinical crown. An abnormality may not be suspected until radiographs reveal pulp and root changes. Orthodontic treatment can be a successful variation of the usual treatment offered to patients, and is discussed in this case report.

Dentinal dysplasia type I: a report of four cases

Dentinal dysplasia type I is a relatively uncommon condition and four cases are described. The radiographic features in these patients are somewhat different to those reported in other cases in that anterior teeth appeared to be less affected than posterior, and tooth loss was less prevalent. These findings support the proposal that the characteristics of dentinal dysplasia type I can be divided into two subgroups.

Fibrous dysplasia of bone and concomitant dysplastic changes in the dentin

Fibrous dysplasia of bone and dentinal dysplasia have not been classified as related conditions. However, the present report describes a patient with both polyostotic fibrous dysplasia and dysplastic changes in the dentin. One bone lesion was first discovered on the right side of the mandible on a routine roentgenogram. There was an atypical radiolucency apical to a short-rooted molar with an obliterated pulp. Additional lesions were found on the left side of the mandible in the maxilla, in the frontal and occipital bones, in the ilium, in the proximal ulnae, and in the ribs. All lesions demonstrated an increased uptake of Tc99. A biopsy specimen of bone from the right side of the mandible showed small calcified islands in a cell-rich connective tissue. Microscopic analysis of the right first molar showed irregularly shaped dentin with the dentinal tubules arranged in a whorl-like fashion surrounding an almost completely obliterated pulp chamber and canal. Healing after tooth extraction and after the bone biopsy was unremarkable. After 6 months the alveolus was reorganized and the bone patterns appeared normal, although the radiolucent areas inferior to the teeth remained unchanged. The concomitant occurrence of dysplastic changes in bone and teeth may be a sign of a generalized defect in the mesenchymal hard-tissue-forming cells.

A scanning electron microscopic study of dentin dysplasia type II in primary dentition

Dentin dysplasia type II is a rare autosomal dominant defect which affects dentin formation in both the deciduous and the permanent dentitions. The scanning electron microscopic study performed on a primary central incisor presents some findings similar to those reported in dentinogenesis imperfecta. Because of the lack of published reports on dentin dysplasia type II, it is difficult to ascertain definitive characteristics of this dentin abnormality.

Dentin dysplasia type I: a clinical report

A case of dentin dysplasia type I (radicular) is described. The practitioner should be aware that several periapical radiolucent areas may occur. If periodontal communication occurs, infection follows. Because of the abnormal anatomic configuration of pulp chambers and root canals, endodontic treatment may not be feasible. The shortened roots may also allow hypermobility and spontaneous exfoliation at an early age. Such patients may be doomed to prosthetic replacements. Well-fitting, esthetic appliances are essential for appearance and function.

Radiographic manifestations of an unusual combination Types I and Type II dentin dysplasia

Dentin dyslasia is a rare autosomal dominant hereditary variant of dentinogenesis imperfecta. The primary defect is mesodermal and involves the dentin. Two types (Type I and Type II) of dentin dysplasia have been described previously. The current case presents radiographic findings which include characteristics common to both types. It is proposed that either a third type (Type III) be recognized or the variability of the developmental defect precludes definitive subclassification.

Dentine dysplasia with sclerotic bone and skeletal anomalies inherited as an autosomal dominant trait. A new syndrome

Patients with teeth showing all of the clinical, radiographic, and histologic features of radicular dentine dysplasia (type I) have been found to have dense sclerotic bone and skeletal anomalies of the wrists and hand bones. The association of these defects of teeth and bone was found to be transmitted as an autosomal dominant trait over four generations. Review of theliterature failed to disclose a previous description of this disorder.

[A rare dental abnormality: "the phantom tooth" or "odontodysplasia". Apropos of a case]

"Phantom tooth" or "odontodysplasia" is one of the most unusual and rare of dental abnormalities, being characterised: Clinically, by the topography of the lesions, the involvement of both sets of teeth and abnormalities in the size and form of the teeth which remain unrupted or only partially evolved. Radiologically, by transparency of the teeth to X-rays. Histologically, by disorganisation of the dental structures and a highly characteristic appearance of the enamel and, in particular, dentine. On the basis of one case, the authors review in detail each aspect of these characteristics, paying special attention to histology and the information obtained using the sweep electron microscope.

Polarized light study of enamel and dentin dysplasia

Twelve teeth from three patients with enamel and dentin dysplasia were investigated by polarized light microscopy. Clinically and radiographically, the changes were similar to amelogenesis imperfecta. Polarized light examination revealed poorly mineralized enamel and regions of dysplastic globular masses in enamel. The dentinal tubules were sparse, irregular, and tortuous.