Abnormalities in enamel structure and their association with systemic diseases and syndromes

Abstract

Etiology of abnormalities in tooth structure has been subject of numerous studies but still has not been fully understood. Heredity is an established etiological factor for many types of structural anomalies of the teeth. Factors that cause changes in enamel structure may be genetic, immunologic and teratogenic or systemic diseases. Genetic changes may include individual genes, micro deletions or chromosomal defects. Systemic diseases can be associated with anomalies of tooth structure and diversity of clinical picture requires a multidisciplinary approach to the therapy. Amelogenesis imperfecta (AI) represents a large group of structural abnormalities of the teeth. AI can exist independently or as a part of large number of syndromes and systemic diseases. Knowledge of clinical presentation, etiology, pathogenesis of structural anomalies of the teeth and their association with certain systemic diseases is of great importance to everyday dental practice in terms of prevention, prognosis and therapy. Also, it is necessary to expand basic knowledge of pediatricians in regards to the clinical picture of anomalies in tooth structure and their possible association with a wide range of systemic diseases and syndromes, in order to provide comprehensive clinical treatment. Therefore, the aim of this study was to present etiopathogenesis and classification and to describe the most important abnormalities of enamel structure and their association with systemic diseases and syndromes

Ghrelin hormone might have a potential role in amelogenesis

“…Enamel formation is meticulously controlled in ameloblasts via the interaction of a series of enamel matrix molecules. [1][2][3][4][5][6][7][8] Therefore, impairment in ameloblast functions as a result of systemic or local factors in the secretory phase causes enamel hypoplasia. Enamel hypoplasia is characterised by enamel surface defects and a reduction in the amount of dental enamel.…”

“…Enamel hypoplasia is characterised by enamel surface defects and a reduction in the amount of dental enamel. [1][2][3]7 If ameloblastic activity is impaired over an extended period, irregular or defective enamel formation occurs in more teeth and larger areas of teeth referred to as generalised enamel hypoplasia (GEH). 2 In GEH, the dentition is affected partially or wholly, and the defects can be seen on any surface of enamel but generally do not cover all surfaces of the crown.…”

“…1,2,7,8,10-13 Hence, well-known possible aetiological factors, multidisciplinary treatment approach and timely diagnosis are essential for the comprehensive and adequate treatment of these patients. 7,8 Although the etiology of GEH is not clearly understood, it may occur as a result of systemic, environmental and genetic factors. 1,2,7,14,15 Up to date, specific causes underlying the occurrence of particular types of enamel hypoplasia have not been identified.…”

“…7,8 Although the etiology of GEH is not clearly understood, it may occur as a result of systemic, environmental and genetic factors. 1,2,7,14,15 Up to date, specific causes underlying the occurrence of particular types of enamel hypoplasia have not been identified. 3 However, those with unknown etiology that occur independently of heredity and teratogenic factors are called idiopathic GEH (IGEH).…”

“…3 However, those with unknown etiology that occur independently of heredity and teratogenic factors are called idiopathic GEH (IGEH). 7 The most common GEH caused by toxicity is dental fluorosis, which occurs when individuals are exposed to high fluoride levels (more than 1 part per million). 15 GEHs of genetic origin are classified under a group of developmental enamel defects known as amelogenesis imperfecta (AI).…”