Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern

Abstract

Regional odontodysplasia (RO) is a rare nonhereditary developmental condition usually affecting maxilla and female patients. A few number of articles have used the cone beam computed tomography (CBCT) to describe imaging findings in RO. Thus, this article aims to report unusual imaging findings in a Brazilian child who presented with mandibular RO. A healthy 8-year-old boy was referred for evaluation of an anterior mandibular gingival enlargement. Radiographically, all right mandibular teeth showed wide pulp chambers and shortened roots with thin dentinal walls and open apices, featuring a “ghost teeth“ appearance, which indicated a diagnosis of RO. Missing teeth and altered radiopacity were observed. Cone beam computed tomography provided great insight into RO, allowing to identify gubernaculum tracts (GTs) associated with RO teeth. Fractal analysis of the bone surrounding RO teeth revealed an altered trabecular pattern.Clinical significanceThis case describes a rare developmental teeth-related pathology in a boy who showed unusual features on imaging exams. The CBCT provided the observation of RO tooth-related GTs, probably a new finding added to the international literature regarding RO, as well as the pulp chamber volume characterization of an affected tooth not published yet. In addition, it was observed an altered fractal pattern of the mandibular bone adjacent to RO teeth, which has not been described to date.How to cite this article: de Sa Cavalcante D, Fonteles CSR, Ribeiro TR, Kurita LM, Pimenta AVM, Carvalho FSR, Costa FWG. Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern. Int J Clin Pediatr Dent 2018;11(2):128-134.

Clinical, Radiographic and Histologic Evaluation of Regional Odontodysplasia: an Unusual Case Report with 6-Year Follow-Up

“…The case in question is that of a 9-year-old girl affected by left Open Access Journal local vascular defect may be involved in the pathogenesis of RO. These nevi are pale pink and gradually disappear with age [19]. In the case presented here, the patient had a haemangioma at birth that remained for up to 8 months after birth at the left mandibular level.…”

“…In this case, multidisciplinary treatment was required (paediatric dentist, maxillofacial surgeon, orthodontist) to achieve correct oral health, preserving the masticatory function, the control of bone development and general dentistry, the monitoring of tooth development with RO for maintenance or surgical treatment if necessary as well as subsequent prosthetic rehabilitation. From 2017 to November 2019, 7 more articles reporting 7 clinical cases were published and provided similar data to those collected by Alotaibi O, et al [9,13,17,19,[24][25][26][27][28].…”

Overview of Radiological Studies on Visualization of Gubernaculum Tracts of Permanent Teeth

“…In our previous reports, we described the successful visualization of the GT in teeth on CT and elucidated the significance of GTs for normal tooth eruption, the characteristics of GTs in delayed or supernumerary teeth, and the usefulness of differential diagnoses between odontogenic and non-odontogenic masses [ 12 , 13 , 14 , 15 , 16 ]. Subsequently, numerous reports on the GT were published [ 5 , 6 , 17 , 18 , 19 , 20 ]. The GCo was previously considered not to be associated with the eruption process [ 3 ].…”

“…In another study, GTs in regional odontodysplasia teeth—the so-called “ghost teeth”—were identified, and all right mandibular teeth showed wide pulp chambers and shortened roots with open apices and thin dentinal walls [ 18 ]. Normal eruption was obscure in these odontodysplasia teeth, so a follow-up study is still required.…”

“…We reported that the imaging characteristics of GTs at the top of odontogenic and non-odontogenic masses were useful for differential diagnoses [ 13 , 14 , 15 , 16 ]. Subsequently, radiological studies on GTs, including our previous reports, began receiving more attention [ 5 , 6 , 17 , 18 , 19 , 20 ]. In this review, we summarize our previous studies, including those on the imaging characteristics of GTs, and review the recent literature on GTs.…”