37: Amelogenesis imperfecta

37 Amelogenesis imperfecta

Summary

Mark is 10 years old. He and his parents are concerned because his teeth seem rough. They also stain easily. What is the cause of these problems? What treatment is possible?

image What can you see in Figure 37.1?

All erupted teeth have hypoplastic enamel.

image

Fig. 37.1 Hypoplastic amelogenesis imperfecta.

History

Mark’s mother says that she noticed when the teeth first erupted that they were rough. They pick up stain and are difficult to clean. What key questions do you need to ask?

image Was there any systemic illness from birth to early childhood?

No.

image Were the primary teeth similarly affected?

There was a slight roughening of the primary teeth, although nothing as bad as the permanent teeth.

image Is anyone else in the family similarly affected?

Mark’s father and his cousin (father’s brother’s son) have similar roughness of their teeth.

After having obtained this history it is most likely that Mark has an inherited enamel defect involving enamel – amelogenesis imperfecta. However, defective enamel formation may be caused by genetic or environmental factors. The defective enamel will exhibit either hypoplasia, due to deficient matrix production, or hypomineralization, from imperfect mineralization of the matrix proteins. In hypoplasia the enamel may be thin, grooved or pitted, whereas in hypomineralization it may appear mottled but of normal thickness. The complete range of the causes of developmental abnormalities of enamel are shown in Box 37.1.

Box 37.1 Developmental abnormalities of enamel

General factors

• Genetic:

• Primarily involving enamel – amelogenesis imperfecta.
• Associated with generalized defects.

• Systemic (chronological):

• Nutritional deficiencies.
• Metabolic or biochemical disorder.
• Toxic substances.
• Infectious illnesses: pre-natal; peri-natal; neonatal; infancy; early childhood.

• Idiopathic.

Local factors

• Trauma.
• Infection.

Enamel defects of genetic origin may occur either as a phenomenon primarily involving the enamel, with possible secondary effects in other dental tissues and craniofacial structures, or as a component of a more complex syndrome in which defective enamel is only one of a number of more generalized abnormalities.

Medical history

Mark has no medical problems. He is doing very well at school and is a keen basketball player.

Examination

Intraoral examination revealed that all the surfaces of all the erupted permanent teeth are affected by a roughness or ‘pitting’ (Fig. 37.1). The second primary molar teeth that were still present were also affected by a similar roughness that, although not as evident on visual examination, was obvious on tactile examination with a probe. There was no tooth wear.

image Why is this pattern of enamel hypoplasia unlike/>

Related posts:

  1. 40: Oral ulceration
  2. 33: Tooth discoloration, hypomineralization and hypoplasia
  3. 22: Nursing and early childhood caries
  4. 12: Increased overbite
  5. 30: The fractured permanent incisor root
  6. 38: Dentinogenesis imperfecta

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Jan 2, 2015 | Posted by in Orthodontics | Comments Off on 37: Amelogenesis imperfecta

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