Regional odontodysplasia: an unusual case with a conservative approach

Regional Odontodysplasia with Generalised Enamel Defect

“…However, there are few features which are rarely reported like radiographic evidence of a normally developing permanent successor (upper right first premolar) to follow affected primary predecessor (upper right first primary molar) [20] or the generalised enamel hypomineralization and hypoplasia affecting the other primary teeth which have not been reported in any case of regional odontodysplasia. The enamel defects seen in teeth with ROD are usually severe [13, 27]; however the remaining teeth usually have normal enamel and dentine [1]. In this case, the severity and pattern of mineralisation defects seen in the unaffected teeth by ROD, mineralization of the permanent successors, size of the pulp, and radiographic features do not conform with the diagnosis of ROD.…”

“…Early extraction of the affected teeth has been proposed by many authors [13, 16, 22, 27] as these teeth might develop dental pathology even in the absence of dental caries due to the thin enamel layer and the presence of enamel and dentinal cleft which allow ingress of microorganism to the dental pulp [1]. In addition, the defective mineralisation of the involved teeth results in undesirable appearance and poor dental aesthetics.…”

“…The extraction was followed in some cases by prosthetic replacement [40, 41]. Some authors have argued for maintaining the noninfected affected teeth to allow normal jaw development and reduce the risk of psychological trauma associated with premature tooth loss [24, 27]. Other treatment approaches in ROD include coverage restorations [25] and autotransplantation of teeth in the permanent dentition [20].…”

“…Patients with regional odontodysplasia usually present with pain and dental abscess formation [21–23] which can be seen even in the absence of dental caries [24]. Other presenting complaints include delay or failure of eruption [14, 25], gingival swelling [26, 27], and abnormal clinical appearance of the teeth [1]. Clinically, affected teeth are usually smaller than normal with a rough surface texture and extensive pits and grooves.…”

“…Clinically, affected teeth are usually smaller than normal with a rough surface texture and extensive pits and grooves. The enamel is hypocalcified and/or hypoplastic with a yellow or brown discolouration and can be soft on exploration with a dental probe [27]. Affected teeth are more susceptible to dental caries due to defective mineralisation [28, 29].…”