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

2. 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.

3. 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.

4. 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

5. 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.

6. 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

7. 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

8. 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.

9. 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

10. 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

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