Regional odontodysplasia, diagnosis, and description

Department of Pediatric Dentistry
Lutheran Medical Center

Name: Craig Elice Date: January 22, 2010
Article title: Regional Odontodysplasia: a bibliography.
Author(s): Crawford PJM, Aldred MJ.
Journal: J. Oral Pathology Medicine
Volume (number): 18:251-63
Month, Year: 1989
Major topic: Regional odontodysplasia, diagnosis, and description
Type of Article: Review of Literature
Main Purpose: The article provided an overview of the characteristics of regional odontodysplasia, a differential diagnosis, and an expansive review of the literature.
Findings: 109 cases have been described in the literature that primarily affects the coronal part of the teeth, although the enamel, dentin, pulp and follicle have been involved. It occurs more frequently in females. No consistent family history, pregnancy or birth history , or medical history has been noted. The disorder presents generally at the time of eruption of the primary or permanent teeth and the presenting sign is failure, delayed or partial arrested eruption of teeth or abscesses with no known caries. The teeth are often discolored with roughened surface texture. The maxillary arch is more commonly affected and it is usually in a continuous series although skipping has been reported especially the bicuspid teeth. It has also been reported that permanent teeth can be affected and not the primary teeth, although the authors suspect that the primary teeth were affected and were not recognized as such. Radiographically, these teeth appear as “ghost like” with no contrast between enamel and dentin. The pulp spaces are large and frequently have pulp stones, while the roots are shortened with open apices. Histopathology of the enamel, dentin and cementum is variable. Enamel hypoplasia is common with invaginations communicating with the pulp have been reported. Interglobular dentin in the crown of the teeth is a common finding with amorphous areas resembling cementum or calculus. These characteristics were suggested as pathognomonic of odontodysplasia. The roots of affected teeth tend to have a normal structure. Associated pathology with other disorders has been suggested but is inconclusive. The etiology of the condition is also variable. Vascular and neural crest cell theories, viral, traumatic incidents, medications, syndromal involvement, and metabolic disturbances were all mentioned with uncertain relationships. The authors suggest an idiopathic etiology. Treatment is usually conservative and the teeth are best retained whenever possible to preserve the alveolar ridge for future prosthesis. Extactions are indicated in the case of an abscess with no other complications
Key points/Summary: It is important to recognize regional odontodysplasia as a differential diagnosis in order to rule out other more ominous disorders.
Assessment of article: Good but long article which provides comprehensive information about the full discussion of regional odontodysplasia.