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Case Report

A female child age 11 years reported at Dinesh Dental Clinic, Port Blair, ANDAMANS with the premature exfoliation of teeth both deciduous and permanent teeth .She gave a history of deciduous tooth falling when she was seven months old after 3 to 7 days of eruption

On physical examination : Child is well built, normal gait Height 43” and 35 kg wt.

Extra oral examination: NAD

Intra oral exfoliated 123|1235
54321 |12345

Teeth present 6543|56
654|6

Lip: NAD

Oral Mucosa NAD

Tongue NAD

Alveolar ridge- knife edge in the region of exfoliated teeth

Radiography examination:

OPG: under developed upper and lower jaws

Teeth present 76431|13467
76543|34567

Coronal: normal E/D

Pulp chamber: large

Root: decreased root with the age formation

In some teeth no root formation

Show delayed eruption of teeth for the age group

Patient has no pain and other symptoms

Lab findings

Serum calcium 9.2 mg/dl

Serum Inorganic phosphorus 4.9 mg/dl

Serum Alkaline phosphatase 171 IU/L

Hb% 12.gm%

Haematocrit 33%

Blood sugar- fasting – 74

Blood sugar – PP- 111

TLC 4900/ul

ESR 10 mm/hr

Platelet count 2.40/ul

Platelet on smear adequate

RBC count 4.3 M/ul

MCV 77fl

MCH 28pg

MCHC 36%

Neutrophil 32

Lymphocyte 55

Eosionophil 9

Monocyte 4

Basophil 0, RBC Normocytic Normochromic

WBC- Mild Eosinophilia

No Heamoparasites

Tooth present are UPPER RIGHT 6,5,4,3 UPPER LEFT 5,6 with spacing.

LOWER RIGHT 5,4 and LOWER LEFT 6 only(Small size).All teeth doesn’t resemble normal.

OPG reveals few permanent teeth with spacing

X-RAY Right Wrist AP & Lat( Bone density is normal, Bone alignment is normal, joint spaces and articular margins are normal No lytic /sclerotic lesion noted No evidence of any erosion or eburnation seen, No evidence of # seen, soft tissues are normal.

X-RAY CHEST PA View…
Both lung fields are clear

Both hila are normal in size and position Costophrenic and cardiaophrenic angles are clear Cardiac contour & size are within normal limits.

The rib cage is normal, Soft tissues are normal.
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Based on the history and clinical examination
Dentine Dysplasia(Rootless teeth)
DiscussionDentin Dysplasia (Rootless teeth) is a hereditary defect in dentin formation in which coronal dentin and tooth condition is normal, the root dentin is abnormal with a gnarled pattern and associated shortened and tapered root.

Clinical feature
Normal eruption pattern, bluish cervical region Type I Radicular dysplasia normal crown of regular or slightly amber translucency, tendency toward complete obliteration of pulp chamber abnormal spaces between the teeth malaligned, malpositioned and severe mobility.
Type II coronal Dysplasia-semi transparent opalescent primary teeth normal appearance in the permanent teeth, incomplete obliteration of pulp cavities pulpotomes.
Differential diagnosisVit D deficiency- (Bone formation of upper and lower limbs and palm is normal
Parathhormone deficiency no hormonal imbalance is seen
Cementogensis imprerfecta( cementation formation is normal)