Kamesha McFadden Jesabel De La Garza Sonya Bautista Case Study No. 5 Kamesha McFadden Jesabel De La Garza Sonya Bautista

Patient Assessment: A sixteen year old male visited a dentist for an initial examination. Oral examination revealed a generalized brown-colored dentition. History: The patient stated that his teeth had appeared brown for as long as he could remember . When questioned if other family members had similar appearing teeth, he stated that his father also has brown-colored teeth. The patient appeared to be in an overall good state of health at the time of the dental visit. No significant problems were noted during the medical history and no medications were being taken by the patient at the time of the dental examination.

Examinations: No unusual or abnormal findings were identified during the extraoral examination. Intraoral examination revealed a generalized brown-colored dentition. Examination of the oral soft tissues revealed no unusual findings and no bony abnormalities. Radiographic examination revealed teeth with thin amounts of enamel and areas where the enamel had fractured away.

Regional odontodysplasia (Ghost teeth): Radiographs: Ghost like appearance Reduced radio-density Occasionally no enamel are visible Extremely large pulp chambers Cause: Idiopathic, although a vascular phenomenon has been suggested Treatment: usually extraction Clinical: One or more teeth in the same quadrant are malformed. Very thin enamel and dentin are present. Eruption of teeth is either incomplete or do not erupt at all Erupted ghost teeth are non-functional and malformed Can affect either deciduous or permanent dentition Maxillary anteriors are involved more than the mandibular

Dentin Dysplasia Two sub-categories: Type I, radicular dentin dysplasia Autosomal-dominant inheritance pattern Disturbance of the Hertwig epithelial root sheath Radiographs: Total or partial lack of pulp chambers and root canals Normal crowns & abnormal roots Both primary and permanent dentition are equally affected Normal color of teeth Type II, coronal dentin dysplasia Autosomal dominant inheritance Translucent teeth with amber color in primary dentition Permanent teeth have normal crown formation with normal color Radiographs Lack pulp chambers and show small root canals.

Amelogenesis Imperfecta Inherited condition that affects the enamel of teeth No associated systemic effects 4 Sub-categories Type I Hypoplastic amelogenesis imperfecta: Tooth enamel does not develop to normal thickness Failure of ameloblasts Radiographs: Abnormal enamel contrasts with dentin Pitted, local, smooth, rough, and enamel agenesis More than one tooth can have a normal clinical appearance Observed mostly on labial and buccal surfaces of permanent teeth Type II Hypocalcified amelogenesis imperfecta: Normal enamel thickness Yellow to orange appearance Very soft enamel at eruption Enamel rapidly lost leaving exposed dentin Associated with anterior open bite Radiographic: Enamel has moth-eaten appearance and is less radiopaque than dentin

Amelogenesis Imperfecta Continued… Type III Hypomaturation amelogenensis imperfecta: Normal enamel thickness Soft enamel surface which chips easily from the crown. Mottled appearance Usually has a snow-capped appearance presenting a whitish discoloration of enamel. Radiographs: Enamel has almost same radiodensity as dentin Type IV Hypoplastic-Hypomaturation: Thin enamel Yellow to brown in color Radiographic Enamel radiodensity similar to dentin Single rooted teeth with large pulp chambers Molar teeth appear as taurodonts

Dentinogenesis Imperfecta: Inherited Bulbous crowns Color varies from opalescent brown to brownish blue Dentin is very soft Chipping of enamel gives appearance of attrition Radiographic: No pulp chambers or pulp canals Abnormal dentin is present.

Internal Resorption: Usually involves only one tooth Usually associated with an inflammatory response in the pulp Clinically it may be seen as a pinkish area in the crown and dental hard tissues start to resorb

Clinical diagnosis: Based on the information provided, which one of the following is the most likely diagnosis? Regional odontodysplasia Dentin Dysplasia Amelogenesis imperfecta Dentinogenesis imperfecta Internal resorption

Resources Ibsen, Olga A.C., Phelan, Joan Andersen. Oral Pathology for the Dental Hygienist: 6th Edition. Missouri, 2014. Print.