Clinical diagnosis and management strategies of amelogenesis imperfecta variants

Resident: Adam J. Bottrill
Date: 05FEB10
Region: Providence
Article title: Clinical diagnosis and management strategies of amelogenesis imperfecta variants
Author(s): Seow, W. Kim
Journal: Pediatric Dentistry
Page #s: pp. 384-393
Year: 1993
Major topic: Amelogenesis Imperfecta
Minor topic(s): None
Type of Article: Topic Summary

Main Purpose: The aim of this study was to analyze the clinical presentations, diagnostic factors and clinical complications of different variants of AI.

Overview of method of research: Patient study and comparison. 32 patients from 17 families.

Key points in the article discussion:

I. AI is a group of inherited disorders primarily affecting dental enamel.
A. Prevalence: from 1:718 to 1:14000 depending on population.
B. Etiology: Alteration of the genes involved in the complex process of enamel formation and maturation.
C. Dx: 1-generalized enamel hypoplasia in primary and permanent teeth. 2-FHx or new mutation 3-absence of systemic factors.

II. Hypoplastic: characterized by deficiency in quantity of enamel (thin enamel or pits and grooves)
A. Pitted (autosomal dominant): small, pinpoint size pits in rows, localized enamel loss, normal radiographs
1. Clinical Problems: Mostly esthetic, mild gingivitis
B. Local (autosomal recesive): horzontal bands of pitting or missing enamel, opaque enamel, normal radiographs.
1. Clinical Problems: Esthetic and sensitivity.
C. Smooth, thin (autosomal dominant): thin, hard, smooth, glossy enamel, colored from white to brown, narrow teeth, no contacts, thin enamel on radiograph.
1. Clinical Problems: Esthetics, sensitivity, loss of VDO, better gingival health than other types.
D. Smooth (X-linked): lyonization, vertical ridges and grooves, thin enamel on radiograph. Father can’t trasmit.
1. Clinical Problems: Esthetics, loss of VDO, gingivitis.
E. Rough (autosomal dominant): thin, hard, rough enamel, minimal contacts, thin enamel on radiograph
1. Clinical Problems: Esthetics, sensitivity, loss of VDO, gingivitis.

III. Hypocalcified: characterized by enamel that is insufficiently mineralized (soft, discolored enamel)
A. (autosomal recessive/dominant): soft, opaque, yellow enamel, chips away easily, adequate contacts, MINIMAL contrast between dentin and enamel on radiograph.

IV. Hypomaturation: characterized by abnormalities in the maturation stages of dev (opaque, chalky enamel)
A. (autosomal recessive/x-linked recessive): opaque enamel, normal contacts, mild open bite, lack of contrast between enamel and dentin on radiograph, similar appearance to fluorosis,

Assessment of article: Basic and informative. Shenanigans were not found here.