Hypoplasia of teeth
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Hypoplasia - underdevelopment of the enamel (the upper layer of the crown of the tooth), less often - dentin (the bone substance of the tooth, which makes up its bulk) of both milk and permanent teeth.
Hypoplasia is much more common in childhood, on inconsistent teeth. If a child has chronic somatic pathology, the risk of hypoplasia is approximately 50%; about a third of the population is susceptible to this disease to one degree or another.
Pathology is formed due to the underdevelopment of the array of tooth tissues (or teeth) due to metabolic disorders. Changes in enamel or dentin are not spontaneously corrected and are lifelong.
Hypoplasia - underdevelopment of tooth enamel
Causes and risk factors
The main prerequisite for the development of hypoplasia is defective processes of mineralization of dental tissues due to the pathology of protein and mineral metabolism. During the formation of tooth rudiments in conditions of impaired metabolism, the functions of enameloblasts, the cells that form enamel, suffer. The result of the incorrect functioning of these cells is the appearance of various defects in the tooth tissues.
Insufficiency of enameloblasts can occur both in the prenatal period and in the first year of a child's life, when active processes of formation and mineralization of the rudiments of milk and permanent teeth take place.
The reasons for violations of mineral and protein metabolism, leading to hypoplasia of enamel and dentin:
- diseases of the central nervous system, accompanied by a violation of the exchange of calcium and phosphorus;
- endocrine pathology (diseases of the thyroid and parathyroid glands);
- acute infectious processes in a newborn (for example, osteomyelitis);
- intoxication with indigestion and loss of significant volumes of fluid and minerals (dysentery, etc.);
- intrauterine infections (syphilis, TORCH infections), transmitted by the mother during pregnancy, respiratory viral diseases, influenza, etc.;
- rickets;
- hemolytic anemia;
- toxicosis, gestosis in the mother;
- hypovitaminosis C, D, E in a newborn;
- aggravated allergological history, atopic dermatitis;
- eating disorders.
Risk factor for dental hypoplasia - diseases of the thyroid or parathyroid glands
In addition to metabolic disorders, the cause of enamel and dentin hypoplasia can be injuries of the upper and lower jaws. Also, a number of studies indicate the possibility of genetically determined damage to tooth tissues.
The risk factor for congenital hypoplasia is prematurity.
Forms of the disease
In accordance with the prevalence of the process, the following forms of dental hypoplasia are distinguished:
- systemic - all teeth or their absolute majority are affected (develops in the prenatal period);
- local - single teeth are involved in the pathological process (the result of inflammatory processes or injuries);
- focal - damage to several adjacent teeth (can be noted in absolutely healthy children).
Systemic hypoplasia affects all or most teeth
By morphological manifestations:
- spotted;
- wavy;
- bowl-shaped;
- furrowed;
- erosive;
- marginal;
- "Tetracycline teeth";
- teeth of Hutchinson, Fournier, Pfluger, Turner.
Depending on the condition of the surface of the defect, hypoplasia is:
- smooth;
- dull;
- shiny.
By severity:
- easy;
- moderate;
- severe (up to the complete absence of enamel - aplasia).
According to the presence of concomitant pathology and complications, the following are distinguished:
- hypoplasia in the spot stage;
- hypoplasia at the stage of usures and defects;
- hypoplasia complicated by caries;
- hypoplasia combined with caries;
- hypoplasia, complicated and combined with caries;
- enamel aplasia.
Symptoms
The main symptoms of the disease are:
- the appearance of stains, grooves, irregularities and other defects with a clear or blurred outline on the enamel of the tooth (teeth);
- roughness and pigmentation of the enamel;
- shortening of the roots of the teeth;
- symmetrical nature of the lesion, often multiple;
- change in bite;
- shortening of dental crowns;
- thinning of dentin;
- expansion of channels;
- increased sensitivity to temperature effects;
- depressions on the surface of the teeth with thinning or absence of enamel at the bottom of the defect.
Hypoplasia is characterized by increased sensitivity of the teeth.
"Tetracycline teeth" is a pathology that develops during the treatment of a mother during pregnancy or a child of the first year of life with drugs of the tetracycline series. Hypoplasia in this case is manifested by a specific green-brown, brown or yellow-brown staining of the enamel (and in severe cases, dentin).
The symptom of Hutchinson's teeth (Hutchinson's) is a characteristic barrel-shaped shape (the width of the neck of the tooth exceeds the width of the crown), combined with moon-shaped notches on the free edge of the incisors, atrophy of their chewing surface and (often) the absence of enamel.
Fournier's teeth are similar in appearance to Hutchinson's; the main difference is the absence of a semi-moon notch on the cutting edge - it is absolutely flat.
Pfluger's teeth are a consequence of improper dentin formation, which is manifested by the conical shape of the first molars (large molars).
All three of these types of dental hypoplasia are characteristic of the congenital syphilitic process.
Turner's teeth are characterized by the presence of chalky spots on the enamel, which, after eruption, may undergo pigmentation; large molars are more often affected. Sometimes a deformation of the crown with partial or complete absence of enamel is detected. A single character and asymmetry of the lesion are specific for this pathology.
Diagnostics
Enamel and dentin hypoplasia is diagnosed based on:
- characteristic clinical picture;
- X-ray examination (changes in the roots of teeth, canals, hard tissues are revealed);
- fluorescent stomatoscopy (there is no extinguishing of the glow in the places of localization of spots);
- the results of vital staining (there is no staining of enamel defects with dyes);
- assessing the dynamics of the process (the stability of pathological changes is established).
Dental hypoplasia has a vivid clinical picture, diagnosis is not difficult
Treatment
The choice of a method for treating hypoplasia in each case depends on the depth and extent of the defect, the severity of the violation of mineral metabolism, the degree of deterioration in the aesthetic appearance of the teeth.
Conservative treatment of enamel and dentin hypoplasia consists in saturating the tooth tissues with minerals (remineralizing therapy).
Microabrasion or bleaching of hypoplastic areas is used with a small lesion area and can eliminate small superficial cosmetic defects of the enamel.
Replacement of the affected tissues is performed when it is impossible to eliminate the defect in a less traumatic way. The main directions in this case are the restoration of hypoplastic areas with composite material, the installation of veneers and lumineers, metal-ceramic, ceramic, metal-plastic crowns.
Possible complications and consequences
The main complications of dental hypoplasia are the progressive destruction of enamel and dentin, the addition of a carious process.
Forecast
With timely treatment, the prognosis is favorable.
Prevention
Prevention of enamel hypoplasia includes the following measures:
- prevention of rickets (taking vitamin D 3);
- timely treatment of chronic inflammatory diseases when planning pregnancy;
- good nutrition for a young child;
- mandatory systematic hygiene procedures for oral care in young children;
- periodic sanitation of the oral cavity.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
