Dentinogenesis imperfecta is a development-related malformation of the dentin with considerable consequences for the entire hard tooth tissue. The teeth show opalescent discoloration and structural changes of enamel and dentin. They are therefore also called glass teeth.
The English term is dark teeth or crownless teeth. The teeth show a bluish transparent discoloration and the enamel becomes cracked and missing, partly because its substructure, the dentine, is malformed. The dentine structure is completely abnormal and has no dentine tubules or completely irregular dentine tubules.
Due to the abrasion during chewing, the enamel is destroyed more and more, so that the dentine is exposed and chewed off bit by bit. X-rays show a reduced contrast of the hard tooth tissue. The roots of the teeth may also be shortened.
The pulp cavity and the root canal may be completely blocked by dentin. If a residual pulp is still present, no secondary dentine can be formed from it, as no odontoblasts are present. In general, however, there is no pulp left.
This also explains the absence of pain, although the dentin may have been chewed away down to the gums. Untreated, the teeth can be chewed down to the gums. The cause of dentinogenesis imperfecta lies in the early developmental phase of the teeth and is determined by a gene.
The predisposition is hereditary. During the development of tooth structure, the replacement of dentine-forming cells by other cells leads to an undersupply of minerals to the dentine and enamel, which is replaced by increased water retention. This leads to the malformation of the teeth, which, however, only becomes apparent after the breakthrough. This malformation can occur in the milk teeth as well as in the permanent teeth.
Therapy
The therapy of dentinogenesis imperfecta is particularly aimed at preventing further abrasion and restoring esthetics. First of all, the carious defects must be removed by means of a dental filling. In the posterior region, the teeth are restored with metal crowns, after any already badly damaged tooth crowns have been provided with a build-up.
In the anterior region, the teeth are restored with plastic or porcelain crowns. This procedure prevents the destruction of the teeth from progressing and restores the disturbed aesthetics. If left untreated, the condition of dentinogenesis imperfecta will continue to deteriorate. After a thorough dental treatment with fillings, abutments and crowns, it is possible to restore the patient’s teeth to a normal appearance.
Summary
Dentinogenesis imperfecta is a hereditary, genetically determined disease. It leads to a malformation of the dentin with the consequence that the tooth enamel also loosens due to the disturbed dentin substructure and releases the dentin. Due to abrasion during chewing, the dentin can be broken down to the gums. The restoration of aesthetics and the prevention of further damage is achieved through extensive dental care.
