A novel type of developmental dentin defect.

P L Lukinmaa, J Waltimo, P Hölttä, L Risteli, J Risteli, S Alaluusua
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Abstract

We describe a developmental dentin disorder distinct from dentin defects characterized thus far. The proband was a 9-year-old boy who was the only family member known to be affected in five generations. The dental defect was not associated with any general disease or developmental disorder. The teeth appeared normal with the exception of the pink hue seen in some primary teeth. Radiographs showed pathological resorption of primary teeth and abnormally shaped pulp chambers and denticles in permanent teeth. Root canals were wide in developing teeth, but appeared thin in erupted teeth. Histological examination of two primary molars revealed canal-like defects in dentin. In the crown, the canals appeared as clusters, which alternated with columns of normal tubular dentin, and in the virtually atubular root dentin they were haphazardly distributed. Scanning electron microscopic examination confirmed the distribution pattern of the canals. In transmission electron microscopy, the defects were found to contain symmetrically banded, segmental collagenous structures. The canal contents immunostained with antibodies to the N-terminal propeptide of type I procollagen, suggesting retention of the propeptide extension in type I collagen. Whereas type III collagen reactivity was barely detectable in the canal region, staining for type V collagen and the non-fibril-forming type VI collagen was strong. The findings imply that the pathogenesis of the defect could be related to a local failure of odontoblasts to produce normal dentin matrix.

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一种新型的发育性牙本质缺陷。
我们描述了一种发育性牙本质障碍,不同于迄今为止表征的牙本质缺陷。先证者是一名9岁的男孩,他是已知的五代人中唯一一个患有此病的家庭成员。牙齿缺陷与任何一般疾病或发育障碍无关。牙齿除部分乳牙呈粉红色外,其余均正常。x线片显示乳牙的病理吸收,恒牙的牙腔和牙髓形状异常。发育中的牙齿根管较宽,而出牙的根管较薄。两颗初生磨牙的组织学检查发现牙本质有管状缺损。在牙冠上,根管呈簇状,与正常管状牙本质柱状相间,而在虚拟管状牙本质中,根管呈随机分布。扫描电镜检查证实了根管的分布模式。在透射电镜下,发现缺陷含有对称带状、节段性胶原结构。用I型前胶原n端前肽抗体对管道内容物进行免疫染色,表明I型胶原中保留了前肽延伸。而III型胶原在管区几乎检测不到反应性,V型胶原和非原纤维形成的VI型胶原染色很强。研究结果表明,缺损的发病机制可能与成牙本质细胞局部不能产生正常的牙本质基质有关。
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