Abstract:Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pupal morphology. The teeth appear clinically normal in morphologic appearance and color. The teeth characteristically exhibit extreme mobility and are commonly exfoliated prematurely. Radiograph shows obliteration of all pulp chambers, short, blunted and malformed or absent roots with periapical radiolucencies involving apparently intact tooth. This case is reported here becaus… Show more
“…Most published cases had rather sobering outcomes after different therapy approaches. This includes a switch to apical surgery after an unsuccessful endodontic treatment attempt (39) or leaving teeth with periapical lesions untreated (18,35) or tooth extraction, particularly in teeth with short roots (10,19,20,34,36,46). The prognosis of endodontically treated teeth with DD might be described as uncertain.…”
Section: Discussionmentioning
confidence: 99%
“…In the present case report, DD-1 was identi ed based on its speci c radiologic features, including the characteristic root morphology, obliteration of the pulp chambers and root canals, and the presence of several periapical lesions in sound teeth (Fig.1,3). Typically, the roots appear shortened, blunted, and partially malformed (14,16,19,20).…”
BackgroundTo report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.Case presentationA 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth. ConclusionsIn patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
“…Most published cases had rather sobering outcomes after different therapy approaches. This includes a switch to apical surgery after an unsuccessful endodontic treatment attempt (39) or leaving teeth with periapical lesions untreated (18,35) or tooth extraction, particularly in teeth with short roots (10,19,20,34,36,46). The prognosis of endodontically treated teeth with DD might be described as uncertain.…”
Section: Discussionmentioning
confidence: 99%
“…In the present case report, DD-1 was identi ed based on its speci c radiologic features, including the characteristic root morphology, obliteration of the pulp chambers and root canals, and the presence of several periapical lesions in sound teeth (Fig.1,3). Typically, the roots appear shortened, blunted, and partially malformed (14,16,19,20).…”
BackgroundTo report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.Case presentationA 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth. ConclusionsIn patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
Background
To report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia with pulp canal calcification (PCC) and apical periodontitis based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.
Case presentation
A 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (12, 15, 26, 31, 32, 36 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth.
Conclusions
In patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
“…DD‐I is a rare disease with an autosomal dominant pattern of inheritance (Shields et al., ) that affects either the primary or both the primary and the secondary dentitions with an incidence of 1/100,000 (Kalk, Batenburg, & Vissink, ). The condition was first described as “rootless teeth” by Ballschmiede (Chamberlain & Hayward, ) in 1920; however, it was Rushton who named the condition “dental dysplasia” in 1939 (Malik, Gupta, Wadhwan, & Suhasini, ). Patients with DD‐I always present with either mobile teeth or pain associated with numerous periapical radiolucencies in non‐carious teeth (Khandelwal & Likhyani, ).…”
Section: Introductionmentioning
confidence: 99%
“…The condition was first described as "rootless teeth" by Ballschmiede (Chamberlain & Hayward, 1983) in 1920; however, it was Rushton who named the condition "dental dysplasia" in 1939 (Malik, Gupta, Wadhwan, & Suhasini, 2015). Patients with DD-I always present with either mobile teeth or pain associated with numerous periapical radiolucencies in non-carious teeth (Khandelwal & Likhyani, 2014).…”
Hereditary dentin disorders include dentinogenesis imperfecta (DGI) and dentin dysplasia (DD), which are autosomal dominant diseases characterized by altered dentin structure such as abnormality in dentin mineralization and the absence of root dentin. Shields classified DGI into three subgroups and DD into two subtypes. Although they are all hereditary dentin diseases, they do not share the same causative genes. To date, the pathogenic genes of DGI type I, which is considered a clinical manifestation of syndrome osteogenesis imperfecta, include COL1A1 and COL1A2. Mutations of the DSPP gene, which encodes the dentin sialophosphoprotein, a major non-collagenous protein, are responsible for three isolated dentinal diseases: DGI-II, DGI-III, and DD-II. However, DD-I appears to be special in that researchers have found three pathogenicity genes-VPS4B, SSUH2, and SMOC2-in three affected families from different countries. It is believed that DD-I is a genetically heterogeneous disease and is distinguished from other types of dentin disorders. This review summarizes the DD-I literature in the context of clinical appearances, radiographic characteristics, and functions of its pathogenic genes and aims to serve clinicians in further understanding and diagnosing this disease.
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