Morphological Study of Dental Structure in Dentinogenesis Imperfecta Type I with Scanning Electron Microscopy

Abstract

Background: Dentinogenesis imperfecta type I (DGI-I) is a hereditary alteration of dentin associated with osteogenesis imperfecta (OI). Aim: To describe and study the morphological characteristics of DGI-I with scanning electron microscopy (SEM). Material and methods: Twenty-five teeth from 17 individuals diagnosed with OI and 30 control samples were studied with SEM at the level of the enamel, dentin–enamel junction (DEJ) and four levels of the dentin, studying its relationship with clinical–radiographic alterations. The variables were analysed using Fisher’s exact test, with a confidence level of 95% and asymptotic significance. Results: OI teeth showed alterations in the prismatic structure in 56%, interruption of the union in the enamel and dentin in 64% and alterations in the tubular structure in all of the cases. There is a relationship between the severity of OI and the morphological alteration of the dentin in the superficial (p = 0.019) and pulpar dentin (p 0.004) regions. Conclusions: Morphological alterations of the tooth structure are found in OI samples in the enamel, DEJ and dentin in all teeth regardless of the presence of clinical–radiographic alterations. Dentin structural anomalies and clinical dental alterations were observed more frequently in samples from subjects with a more severe phenotype of OI.

SEM/EDS Analysis of Tubules and Mineral Deposition in the Dentin of Children with Osteogenesis Imperfecta

“…In previous studies, it has been hypothesized that the alteration of the dental microstructure is secondary to dysfunction of the odontoblasts due to intracellular accumulation of abnormal procollagen and collagen degradation products [11] or rapid obliteration of the dentinal tubules due to aberrant mineralization of the dentin [19]. In fact, the evidence seems to support the theory that the initial dentinal secretion would be normal if the formation of aberrant dentin begins later, since according to several authors [14,20,21], the outermost dentin has normal morphology, with a layer parallel to the dentin-enamel junction (DEJ) of dysplastic dentin continuing alternating dysplastic and tubular zones up to the pulpal tissue.…”

“…In addition, it has been confirmed that the microstructural alteration occurs even in teeth that do not appear to show signs of clinical and/or radiographic signs of DGI-I [19,20,22]. The dentin alterations described in the literature are mainly a decrease in tubular diameter and density, with an abnormal pattern in the direction of the dentinal tubules and a dysmorphic appearance [11,14,19,20]. The severity of dentin alteration has also been related to the systemic alteration (OI), with dentin being more dysmorphic in the most severe OI phenotypes [20].…”

“…Although microstructural alterations are found in the enamel and DEJ in subjects with OI, DGI-I mainly manifests in dentin. In a study involving Spanish children with OI, it was determined that there were alterations in more than half of the deciduous teeth at the enamel (64% prevalence) and the DEJ level (64-72% prevalence), and in the dentin in all the analyzed teeth [20]. In addition, it has been confirmed that the microstructural alteration occurs even in teeth that do not appear to show signs of clinical and/or radiographic signs of DGI-I [19,20,22].…”

“…In a study involving Spanish children with OI, it was determined that there were alterations in more than half of the deciduous teeth at the enamel (64% prevalence) and the DEJ level (64-72% prevalence), and in the dentin in all the analyzed teeth [20]. In addition, it has been confirmed that the microstructural alteration occurs even in teeth that do not appear to show signs of clinical and/or radiographic signs of DGI-I [19,20,22]. The dentin alterations described in the literature are mainly a decrease in tubular diameter and density, with an abnormal pattern in the direction of the dentinal tubules and a dysmorphic appearance [11,14,19,20].…”

Dentinogenesis imperfectában és hemofília A betegségben szenvedő tinédzser protetikai ellátása

“…A dentinogenesis imperfecta (DI) egy autoszomális dominánsan öröklődő betegség, amelyet a dentin súlyos hipomineralizációja és megváltozott szerkezete jellemez [1], izoláltan vagy az osteogenesis imperfecta (OI) néven ismert genetikai rendellenességgel társul [2,3]. A dentinogenesis imperfectát Shields és munkatársai [4] három kategóriába sorolták: az I-es típus az osteogenesis imperfectával társul, itt a tejfogak súlyosabban érintettek, mint a maradó fogak.…”