Imperfect amelogenesis is a rather rare genetic disease, which is a violation of enamel formation with further destruction of the tooth structure. The formation of defective enamel can disrupt the mineralization of the teeth. In the future, discolorite may be observed along with a change in the color of the enamel, which begins to acquire a brown or gray tint. A disease such as imperfect amelogenesis is rarely seen in its pure form. As a rule, other dental disorders accompany this disease. For example, there are imperfect amelogenesis and dentinogenesis, the latter acts as a hereditary malformation of dentin. The combination of two pathologies is called Stanton-Capdepon syndrome. Next, we find out what are the main causes, and, in addition, the symptoms of the development of this disease, and find out how the diagnosis and therapy of the pathology under consideration are carried out.
Pathology Description
Imperfect amelogenesis is a concern for many people. This ailment suggests a violation of the process of formation of enamel. The described disease is observed in men and women. But it is worth noting that among the fair sex this disease is recorded much more often.
This dental disease is usually inherited. The final factors of its occurrence have not been studied. Key causes of the onset of the disease are gene mutations. They can manifest themselves in different ways. People may form a thin layer of enamel or it may be completely absent. The color of the enamel also often changes. It is opaque brown or white.
In case of imperfect amelogenesis, the teeth are similar to gypsum; they have no shine.
In some cases, the enamel has a rough surface. With a similar clinical picture, the thickness of the outer protective shells of the teeth decreases slightly.
Classification of imperfect amelogenesis
There are 4 main forms of the disease.
- Hypoplastic form. The whole fault is a violation of the differentiation of tissues and the secretory activity of ameloblasts.
- Hypomaturization. The reason for this is a failure at the stages of formation and primary mineralization of the enamel matrix.
- Hypocalcification form. The mineralization phase is broken. An abnormal growth of crystallites and a decrease in the mineral component of enamel are observed.
- Hypomaturization with hypoplasia and taurodontism. Even at the stage of tissue differentiation and layering of the enamel matrix, a failure occurs.
Hereditary pathologies as factors in the occurrence of a disease
All hereditary pathologies are conditionally divided into two large categories: gene and chromosomal. In dentistry, gene diseases are often found that are transmitted to people from generation to generation even without certain changes. So, in the event that one of the parents was diagnosed with a pathological process in hard dental tissues, then the probability of the appearance of exactly the same ailment in a child is approximately fifty percent. Moreover, anomalies can equally affect both girls and boys, that is, pathology does not depend on gender in any way.
Enamel dysplasia, accompanied by dentin damage, is a serious hereditary pathology caused by a mutation of genes that are responsible for the formation of a specific matrix protein. In a child, this ailment is able to affect milk or permanent teeth.
In the presence of imperfect amelogenesis, the connection of depleted enamel with dentin is disrupted. The layer of hard tooth tissue in this disease has a weak connection. Against the background of the destruction of the enamel and dentin compounds, caries quickly spreads to the area of hard tissues. As a result of this process, as a rule, replacement dentin is formed soon, and the root canals of the tooth, in turn, affect calcification.
The main causes of pathology
Most often, hereditary imperfect amelogenesis is diagnosed. In addition to a hereditary predisposition to the appearance of dentin pathology, doctors distinguish the following reasons:
- The use of certain drugs by a woman during pregnancy, especially antibiotics.
- Failure of the intrauterine metabolism in the baby.
- The appearance of severe toxicosis in the expectant mother, which causes a violation of the intake of nutrients to the child.
- The use of poor-quality water and food in the first years of a child's life.
All of the above factors are not the root causes of amelogenesis. These reasons can only increase the risks of developing pathology in the case of a hereditary predisposition in a child.
Symptoms of pathology
Imperfect amelogenesis may have several variants of its manifestation, each of which will have its own symptomatology.
- Teeth in sick children can come out on time, but will have a smaller size. The distance between them is usually quite large. The enamel will have a smooth structure, and the roots will not be changed.
- The enamel in this disease can have a more pronounced destructive change, and the teeth themselves, as a rule, are formed in the shape of a cone or cylinder. Due to the insufficient calcification of the enamel, its surface has a rough structure. In some places, the teeth are completely bared to the dentin, while their root system itself can develop without any pathology.
- In the presence of the usual size of the teeth, the enamel can have a grooved appearance. In this case, chaotic or vertically located grooves are present on the hard surface of the enamel. Such dysplasia usually affects all teeth.
- In the presence of a normal shape of the teeth, enamel against the background of this disease is very depleted and has a chalky texture. Even with minor injuries, the enamel can easily separate from the dentin. Patients are additionally able to develop hyperesthesia in the form of an exacerbated sensitivity of tooth tissue.
Characteristic signs of the disease
The characteristic manifestations of this disease, regardless of its shape, is the color of enamel, which can vary from a gray tint to brown. Often there are the first and fourth types of enamel dysplasia. This disease accounts for about sixty-six percent of all dental diseases. A disease such as imperfect dentinogenesis is extremely rare in its pure form and is clinically capable of not manifesting itself in any way. The development of this disease can only be indicated by the excessive sensitivity of dentin.
In patients with this disease, enamel may also acquire a purple hue. This color is due to the filling of dentin with blood. Due to a malfunction of mineralization processes, a structural violation of dentin occurs. In the future, a similar process can lead to tooth depletion. Sharp edges may occur on the crowns that can injure the mucous surface of the oral cavity.
Imperfect amelogenesis in children
This tooth pathology in children is, as a rule, non-carious in nature and acts as an extremely dangerous disease. Signs of anomalies in children are practically no different from those in adults. This disease in children has clear symptoms that differ from other dental problems. These signs include:
- The appearance of changes in the color of enamel.
- The presence of increased sensitivity of the teeth.
- The presence of enamel chips.
- The presence of cutting, and, in addition, sharp edges.
- The presence of destruction of the tooth crowns.
- The appearance of spots and bumps on the surface of the enamel.
Dysplasia of primary teeth enamel is most often diagnosed. This dental disease can affect the entire jaw of a child, and, in addition, some of its parts.
Diagnostics
In the presence of imperfect amelogenesis, the clinic must be consulted for examination.
Diagnosis is usually based on a history. In addition, it is necessary to conduct a clinical examination of the patient and perform additional studies. The genealogical method for diagnosing this disease is the most common and effective. In the course of its conduct, the genealogy of the patient is compiled and genealogical analysis is performed.
Differential diagnosis of imperfect amelogenesis is also carried out.
The dentist assesses the current condition of the teeth not only of the patient himself, but also of his relatives. It is extremely important to evaluate the color along with the structure of the enamel, the presence of possible irregularities, and the like. As part of the analysis of genetic material, frequency is noted along with the severity of various hereditary traits. In some situations, the patient is prescribed a radiography, as well as a pulp test for excitability.
Next, find out how the treatment of this disease is currently being carried out.
Disease treatment
Treatment of non-carious diseases of the dental tissue begins with the process of restoration of enamel. The affected tooth surface not only violates the aesthetics of the smile, but can also damage the integrity of the teeth.
In the early stages of the development of pathology, the doctor usually resortes to endodontic therapy, which is aimed at preserving the tooth. To strengthen tooth enamel, the doctor prescribes complex remineralizing therapy. Patients are advised to take calcium preparations along with vitamin and mineral complexes.
What else involves the treatment of imperfect amelogenesis?
For oral and dental hygiene, it is best to use fluoride-containing toothpaste along with rinsing agents. Patients need to undergo a course of fluoridation, as a result of which tooth enamel may strengthen, and as a result, resistance to caries will increase.
In the event that the remineralizing procedure does not bring the proper result, and the integrity of the dental tissues remains impaired, they resort to the prosthetics procedure.
Composite materials are also used. Under an artificial crown, imperfect dentinogenesis can continue to progress, while destroying dentin. Prosthetics against this background will be only temporary and is usually aimed at eliminating aesthetic inconvenience.
When treating a disease in children, remineralizing therapy should be carried out as soon as possible, as soon as the first milk teeth appear. With complex therapy, dentists predict a good result.
Glass ionomer cement
In the event that imperfect dentinogenesis is diagnosed in infants, then glass ionomer cement is used to restore crowns. This material is characterized by good adhesion with dentin and enamel, which provides reliable protection against caries. Glass ionomers can perfectly integrate into a child’s body and do not cause side effects.
Pathology prevention
The best prevention of dental disease is regular visits to dentists. People who have a hereditary predisposition to the occurrence of enamel dysplasia need to visit the dentist’s office at least once every six months. Do not forget about a balanced nutritional diet, and, in addition, about taking vitamin and mineral complexes. A healthy lifestyle, along with quitting smoking and alcohol, always has a beneficial effect on dental health.
Parents should be especially careful. Pediatricians and pediatric dentists strongly recommend that adults monitor the health of the oral cavity of babies. Thus, it is very important to consult a specialist for any dental problem.
We examined the causes, symptoms and diagnosis of imperfect amelogenesis.