Dentinal dysplasia type 1: A 3D micro‐computed tomographic study of enamel, dentine and root canal morphology

Abstract

Dentine dysplasia type 1 is a rare and complex dental anomaly. Our aim was to conduct a morphometric assessment of a dentinal dysplasia type 1c (DD1c) caries-free mandibular second molar, extracted due to symptomatic apical periodontitis. Controls consisted of five intact mandibular second molars. Microcomputed tomography analysis showed that the DD1c volume % for enamel, dentine/cementum and pulp chamber fell in the 0.36th, 99.97th and 0.09th percentiles of the control teeth (P < 0.01). It also revealed an extremely complicated root canal system in the DD1c tooth with a varying degree of dentine mineralisation and aberrant dentine deposition in the pulp chamber. A crack extending from the external tooth surface to the pulp chamber was identified as a potential site for microbial invasion. Clinical implications include preventive measures and early intervention in reversible pulpitis. Conclusion: Micro-CT imaging can be useful in establishing post-extraction diagnosis of cracks and phenomic characterisation of tooth anomalies.

Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report

“…The datasets used and/or analysed during the current case report are available from the corresponding author on reasonable request. Figure 1 Panoramic view of the dentition of a 12-year old female with DD-1: Note the obliterated pulp chambers and root canals of reduced size in all teeth, and periapical radiolucencies in teeth 15,12,26,36,32,31,46.…”

“…Besides aberrant dentin deposition in the pulp chamber in both types (DD-1 and DD-2), most typically in DD-1 there is an increased incidence of periapical radiolucencies due to the infection of the endodontic system (9,13,14). To date, it is presumed that these teeth are highly susceptible to bacterial invasion due to various factors, including the presence of atypical dentin formation within a highly irregular pulp chamber, the lack of dentinal uid, which induces enamel brittleness and, occasionally, micro cracks as a potential pathway for microorganisms, and aberrant dentin formation, which might affect the formation and structure of the enamel as well (15). Alterations to the enamel, including micro cracks and increased dentin permeability in the case of DD-1, may facilitate bacterial invasion and lead to pulp necrosis and apical periodontitis.…”

“…Alterations to the enamel, including micro cracks and increased dentin permeability in the case of DD-1, may facilitate bacterial invasion and lead to pulp necrosis and apical periodontitis. Such a crack was detected in a three-dimensional (3D) micro-computed tomographic study of a molar of a DD-1 patient, but the ability of this technology to detect ne cracks seems to be limited (15).…”

“…This subclassification is of particular significance to the diagnosis of DD1, which had also been termed radicular dentine dysplasia (2). Affected teeth diagnosed as DD1 have often been described as rootless teeth (4), due to excessively shortened or absent radicular structure, There is no available evidence on the occurrence of apical periodontitis in teeth with DD, but several case reports suggest that these teeth may be at risk of developing apical pathologies (10,(14)(15)(16)(17)(18).…”

Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report

“…Besides aberrant dentin deposition in the pulp chamber in both types (DD-1 and DD-2), most typically in DD-1 there is an increased incidence of periapical radiolucencies due to the infection of the root canal system (9,13,14). To date, it is presumed that these teeth are highly susceptible to bacterial invasion due to various factors, including the presence of atypical dentin formation within a highly irregular pulp chamber, the lack of dentinal uid, which induces enamel brittleness and, occasionally, micro cracks as a potential pathway for microorganisms, and aberrant dentin formation, which might affect the formation and structure of the enamel as well (15). Alterations to the enamel, including micro cracks and increased dentin permeability in the case of DD-1, may facilitate bacterial invasion and lead to pulp necrosis and apical periodontitis.…”