OVERVIEW

What is Dentine Dysplasia?

Dentine dysplasia (DD) is a type of hereditary dentin disorder characterized by abnormal morphology or structure of dentin. It is an autosomal dominant genetic disease, typically classified into two types:

• Dentine Dysplasia Type I (DD-I): Clinically, the teeth appear normal in color, shape, and appearance, but radiographically, the roots are sharp and conical with apical narrowing. The pulp chamber of permanent teeth becomes obliterated before eruption, leaving a crescent-shaped remnant parallel to the cementoenamel junction. In primary teeth, the pulp chamber is completely obliterated, often showing periapical radiolucency even without caries.

• Dentine Dysplasia Type II (DD-II): Also known as hereditary opalescent dentin, this type resembles Dentinogenesis Imperfecta Type II. A distinctive feature is the pronounced narrowing of the cervical region, forming a bulbous crown. Permanent teeth may be unaffected or show only mild radiographic abnormalities, such as thistle-tube-shaped pulp chambers and pulp stones.

What is the Inheritance Pattern of Dentine Dysplasia?

It can appear in multiple consecutive generations within a family or skip generations, following an autosomal dominant inheritance pattern.

Are Dentine Dysplasia and Dentinogenesis Imperfecta the Same Condition?

Not exactly.

Some scholars classify dentine dysplasia and dentinogenesis imperfecta under the same category. However, strictly speaking, they are two distinct classifications of hereditary dentin disorders. Dentinogenesis imperfecta is further divided into three types:

• Dentinogenesis Imperfecta Type I: Accompanied by osteogenesis imperfecta, primary and permanent teeth typically appear amber-colored, translucent, and exhibit significant wear.

• Dentinogenesis Imperfecta Type II: Shares similar dental features with Type I but is completely translucent and not associated with osteogenesis imperfecta.

• Dentinogenesis Imperfecta Type III: Clinical manifestations vary. Apart from resembling Type II in tooth size and color, primary teeth in this type have enlarged and extensively exposed pulp chambers. Radiographically, the teeth appear hollow due to dentin atrophy, earning them the nickname "shell teeth."

SYMPTOMS

What are the symptoms and manifestations of dentin dysplasia?

• The tooth crown appears slightly yellow and translucent, displaying an opalescent glow under light.

• The enamel easily separates and detaches from the dentin surface, exposing the dentin and leading to severe masticatory wear.

• In the deciduous dentition, the entire crown may wear down to the gum line, causing functional impairments in chewing, aesthetics, and speech. Severe wear resulting in a low bite may also lead to secondary temporomandibular joint disorders.

• X-rays reveal short roots, and shortly after tooth eruption, the pulp chamber and root canals become completely obliterated.

What conditions should dentin dysplasia be differentiated from?

Enamel hypoplasia, congenital syphilitic teeth, discolored teeth, dental fluorosis, tetracycline-stained teeth.

What serious consequences can dentin dysplasia cause?

Severe wear leading to a low bite may result in secondary temporomandibular joint dysfunction.

CAUSES

What are the causes of dentin dysplasia?

It is an autosomal dominant genetic disorder, which can appear in several consecutive generations within a family or skip generations. The incidence rate is equal in both males and females, and both primary and permanent teeth can be affected. If one parent is affected, there is a 50% chance that their children will inherit the condition, consistent with the pattern of autosomal dominant inheritance.

DIAGNOSIS

How is dentin dysplasia diagnosed?

It is generally diagnosed based on the distinctive appearance of the patient's teeth, X-ray findings, and the patient's family history of the condition.

What tests are required for patients with dentin dysplasia? Why are these tests necessary?

• Routine oral examination: A comprehensive oral examination, including visual inspection, palpation, percussion, and probing, helps identify the affected tooth and provide preliminary differential diagnosis.

• X-ray examination: X-ray imaging of the affected tooth helps confirm the diagnosis, assess the degree of dentin dysplasia, and guide clinical restorative treatment.

What precautions should patients with dentin dysplasia take during oral examinations?

• Rinse the mouth before the examination to maintain clean teeth and oral cavity, ensuring the accuracy of the examination.

• Stay relaxed to better communicate the actual sensations during the examination.

TREATMENT

Which department should I visit for dentin dysplasia?

Dentistry.

Does dentin dysplasia require hospitalization?

No.

How should dentin dysplasia be treated?

• Since severe chewing wear is common in deciduous teeth, occlusal pads covering the surface and incisal edges are needed for prevention and management.

• For permanent teeth, to prevent excessive wear, porcelain crowns or occlusal pads can be used for restoration.

  • Porcelain crowns: A porcelain crown is a type of dental restoration. Its color can be matched to your natural teeth for consistency. The outer surface of the tooth is ground down according to design requirements, and metal is used as the inner crown. Dental-specific ceramic material is then sintered onto the metal surface at high temperatures to restore the tooth's shape, function, and aesthetics.

  • Occlusal pads: The occlusal pads commonly used in clinical practice are made of high-molecular resin material with one soft side and one hard side. They are formed under high temperature and pressure, with a thickness of only about 2 mm, ensuring both strength and the advantages of soft occlusal pads. They maintain normal occlusal relationships, distribute biting forces evenly, and provide greater comfort during use. Their mechanism involves mechanically isolating direct contact between upper and lower teeth, redistributing occlusal forces, and buffering chewing pressure to prevent teeth grinding and avoid further damage to dental and periodontal tissues.

DIET & LIFESTYLE

What should patients with dentin dysplasia pay attention to in their diet?

Avoid chewing excessively hard foods and minimize spicy or irritating foods.

PREVENTION

Can dentin dysplasia be prevented?

Dentin dysplasia is a genetic disorder, and there are currently no effective preventive measures. Early detection and diagnosis are key to management.

How can patients with dentin dysplasia prevent complications?

Conditions like temporomandibular joint disorders may occur when severe tooth wear leads to reduced occlusal height. Therefore, proactive treatment to maintain normal occlusal vertical dimension can help reduce the risk of temporomandibular joint issues.