Smita Kamtane, MDS, BDS

Disclosures

September 26, 2011

Editor's Note

Standard dental care in different international locations may vary based on a variety of factors, such as accessibility to providers, variations in available materials, dental products or procedures, differing societal norms, and affordability of some procedures in low-income countries. This case within a family residing in 1 geographic location in India and may provide useful information to others. Clinical decision-making should be individualized, based on complete clinical assessments of patients with similar presentations.

Case Presentation: Brown, Discolored Teeth

A 25-year-old woman reported to the department of oral medicine and radiology, with complaints of brown discolored teeth and wearing away of her teeth. She requested replacement of her teeth with dental prostheses.

History and Dental Examination

History. The patient claimed that she experienced a similar discoloration and wearing away of her "milk teeth" (primary or deciduous teeth), which had exfoliated uneventfully. Her family history revealed that both of her children and her husband had similar dental problems. Family history included a consanguineous marriage.

Dental examination. Clinical examination revealed interproximal caries in the following teeth: #3, #4, #19 and #30 (Universal System of Numbering). A retained root tip was seen in the area of tooth #14. All teeth were yellowish- brown in color and small in size. Her lower incisors exhibited severe attrition, except for #23, with complete loss of enamel from most teeth or chipping of enamel (Figure 1).

Figure 1. Patient's teeth showing yellow-brown discoloration and foreshortened crowns.

The coronal height of the patient's teeth was reduced to one-third of normal. An orthopantamogram revealed complete obliteration of the pulp chamber and root canal space (Figure 2).

Figure 2. Patient's orthopantamogram, showing bulbous appearance of the crown, complete obliteration of the pulp chamber and no evidence of any root canals.

Dentinogenesis imperfecta is a hereditary condition, inherited as an autosomal dominant trait. An oral examination was performed on 1 of the patient's 2 affected children, and a radiograph was obtained (Figure 3).

Figure 3. An orthopantamogram of the patient's son, showing obliteration of the pulp chamber in the deciduous dentition, some eruption of permanent dentition, and some of the permanent dentition still forming.

Upon oral clinical examination of the patient's son, a grayish-brownish discoloration of the primary and permanent dentition was observed (Figure 4). An orthopantomogram revealed complete obliteration of pulp canals in the maxillary and mandibular deciduous anterior teeth. Dentin on the son's primary molars and permanent dentition appeared within normal range, except for the discoloration noted.

Figure 4. Patient's son. Note similar presentation, showing yellow-brown discoloration, amberlike translucency, and foreshortened crowns.

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