Clinical Management of Regional Odontodysplasia

Resident: Adam J. Bottrill
Date: 16FEB11
Region: Providence
Article title: Clinical Management of Regional Odontodysplasia
Author(s): Cahuana, Abel PhD, MD, DDS
Journal: Pediatric Dentistry
Page #s: 37-39
Vol:No Date: 27:1 2005
Major topic: Odontodysplasia,
Minor topic(s): Ghost Teeth, Tooth Autotransplantation
Type of Article: Case Studies and Discussion

Main Purpose: The purpose of this study was to describe the characteristics and clinical management of 2 patients diagnosed with ROD at the Pediatric Dentistry Service at the Hospital Sant Joan de Deu, Barcelona, Spain.

Key points in the article discussion:

I. General

A. Regional Odontodysplasia (ROD) is a relatively rare localized developmental anomaly of the dental tissue.
B. 1989: Females>Males, no race association
1. Etiological factors: local circulatory disorders, viral infections, pharmacotherapy during pregnancy, facial asymmetry, local trauma, metabolic disturbances, somatic and neural mutations, sundromal involvement.
2. TRUE ETIOLOGY unknown.
C. Clinical criteria:
1. Maxialla>Mandible
2. Usually unilateral, rarely crosses midline
3. Small, brosn, grooved, hypoplastic teeth
4. Eruption failure
5. Abscesses or fistulae in the absence of caries
6. Radiographic lack of contrast between enamel and dentin. Overall less radiodense.
7. "Ghost Teeth"
8. Large pulp chambers with stones or denticles
9. Histological characteristics
10. Bone not affected

II. Case #1:

A. Hx:
1. 5yo boy
2. Pain and inflammation Rt Maxilla.
3. Hx of infections in the area.
B. Exam:
1. Gingival swelling upper Rt maxilla
2. Abnormal morphology, irregular surface and yellow/brown color of teeth in the area
3. Incisors fractured to root level.
4. Tooth morphology otherwise normal
5. "Ghostly appearance"
C. Tx:
1. Sub-G scaling, 3-mo recare
2. Pt returned two months later for follow up. Swelling had returned.
3. Affected primary teeth extracted, acrylic appliance fabricated.
4. Autotransplantation at age 10 due to dentoalveolar discrepancy
5. Current plan is to maintain the autotransplanted teeth until orthodontic and prosthodontic rehabilitation possible.

III. Case #2

A. Hx
1. 3 yo girl presented for abscess in upper left.
B. Exam:
1. Upper left abnormal tooth morphology and abscess of caries.
2. Gingiva swollen and tender on palpation.
3. Ghost teeth.
C. Tx:
1. OHI
2. Acrylic appliance fabricated due to failed eruption.
3. At age 7, waiting for future treatment plans.

IV. Conclusions:

A. Neither case described can be related to any current etiological factors.
B. ROD cases require continuous and multidiscplinary approach.


Assessment of article: Case reports... pretty straight forward. No earth-shattering conclusions.