Amelogenesis imperfecta and localized aggressive periodontitis.

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Journal name: Journal of Indian Society of Periodontology
Original article title: Amelogenesis imperfecta and localised aggressive periodontitis: A rare clinical entity
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Gayatri Gundannavar, Radhika M. Rosh, Shoba Chandrasekaran, Ahad M. Hussain


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Amelogenesis imperfecta and localised aggressive periodontitis: A rare clinical entity

Year: 2013 | Doi: 10.4103/0972-124X.107485

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

This case report details two female patients presenting with tooth discoloration, later diagnosed with amelogenesis imperfecta and localized aggressive periodontitis. Amelogenesis imperfecta is a hereditary disorder characterized by defects in tooth enamel, leading to reduced enamel quantity and quality, potentially causing sensitivity and vulnerability to dental caries. The factors contributing to enamel hypoplasia (EH) include environmental and genetic influences, wherein these defects can manifest differently across individuals and may present in various forms such as hypoplastic, hypomaturation, and hypocalcification types.

Clinical Manifestations of Amelogenesis Imperfecta

In the first case, a 14-year-old female exhibited yellowish-brown discoloration of her teeth associated with enamel hypoplastic type of amelogenesis imperfecta. Significant dental attrition was noted, leading to dentine exposure, alongside periodontal issues including deep pockets indicative of localized aggressive periodontitis. The second case involved a 19-year-old female with an absence of enamel and multiple carious lesions, associated with hypomineralized type. Despite poor oral hygiene and visible periodontal destruction, the latter patient did not pursue treatment following diagnosis. Both cases illustrate the complex interplay between amelogenesis imperfecta and periodontal disease and underscore the necessity for comprehensive clinical assessments and multidisciplinary treatment approaches.

Conclusion

The co-occurrence of amelogenesis imperfecta and localized aggressive periodontitis in these cases highlights a rare clinical entity that may have underlying genetic links, as suggested by previous studies. These findings call for further exploration into the genetic basis of these conditions and their relationship, with the goal of improving diagnosis and treatment strategies. Amelogenesis imperfecta, recognized for its hereditary nature, may contribute to the development of aggressive periodontitis, warranting a deeper understanding within dental practices to optimize patient management and outcomes.

FAQ section (important questions/answers):

What is amelogenesis imperfecta and its clinical significance?

Amelogenesis imperfecta is a hereditary disorder affecting tooth enamel's quality and quantity, leading to defects like discoloration and susceptibility to dental caries. Diagnosis is crucial for appropriate management and treatment.

What are the common types of amelogenesis imperfecta?

The main types include hypoplastic, hypomaturation, and hypocalcification. Each type presents distinct clinical characteristics, ranging from reduced enamel amount to softness and discoloration.

How does localized aggressive periodontitis manifest clinically?

Localized aggressive periodontitis is characterized by rapid bone loss around permanent teeth, particularly first molars and incisors. Clinical signs may be minimal initially, but deep periodontal pockets and tooth mobility can develop.

What treatments are available for amelogenesis imperfecta and periodontitis?

Treatment includes scaling, root planing, and possible periodontal surgery. Restorative options like ceramic crowns may be used for aesthetic rehabilitation, alongside systemic antibiotics for managing aggressive periodontitis.

Is there a genetic link between amelogenesis imperfecta and periodontitis?

There may be a genetic connection, as studies suggest links to chromosome 4. However, further investigations are needed to fully understand the relationship between these conditions.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Amelogenesis imperfecta and localized aggressive periodontitis.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Surface:
In dentistry, 'surface' refers to the outermost layer of a tooth, particularly the enamel in this case report. The condition of the tooth surface is critical, as it affects both aesthetics and functionality, influencing susceptibility to plaque accumulation, caries, and other dental issues, as seen in the presented cases of amelogenesis imperfecta.

2) Inflammation:
Inflammation is the body's response to injury or irritation, which is exacerbated in conditions like localized aggressive periodontitis. In the presented cases, inflammation was evident from the gingival examination, indicating periodontal disease that requires careful management to restore gum health and prevent further deterioration of dental structures.

3) Hygiene (Hygienic):
Oral hygiene encompasses practices that maintain oral health, such as regular brushing and flossing. In the case report, the patients had various levels of oral hygiene which influenced their periodontal health. Appropriate hygiene practices are essential in managing dental conditions and preventing further complications such as severe periodontal disease.

4) Antibiotic (Antibacterial):
Antibiotics are medications used to treat bacterial infections. They play a vital role in managing localized aggressive periodontitis, as demonstrated in the first patient’s treatment plan. The use of antibiotics helps control bacterial proliferation in infected periodontal tissues, contributing to healing and improving overall dental health.

5) Disease:
Referring to an abnormal condition affecting health, 'disease' encompasses both amelogenesis imperfecta and localized aggressive periodontitis in this report. The interplay of these conditions underlines the complexity of dental health, requiring multifaceted approaches for diagnosis and treatment, given their distinct developmental and pathogenic characteristics.

6) Family:
The concept of 'family' is significant in genetic conditions like amelogenesis imperfecta, as evidenced by the family history in the first patient’s case. Genetic predispositions often mean that traits, such as dental anomalies, can run in families, highlighting the importance of familial background in diagnosis and treatment planning.

7) Table:
The 'table' refers to the classification of amelogenesis imperfecta presented in the article. It summarizes the various types of this hereditary condition and aids in understanding the phenotypic manifestations. Such classifications are essential for clinicians to determine the most effective treatment approaches based on the specific type of the disorder.

8) Pur:
In this context, 'poor' describes the inadequate oral hygiene and dental health observed in the second patient's case. Poor hygiene practices can lead to pronounced dental issues, including extensive caries and periodontal disease, necessitating more complex treatment protocols to restore health and functionality to the oral cavity.

9) Irritation:
'Irritation' refers to the discomfort experienced in the context of periodontal disease, often indicated by gum inflammation and sensitivity. It plays a crucial role in the clinical presentation of localized aggressive periodontitis, influencing patient symptoms and affecting management strategies employed by dental professionals in treatment plans.

10) Composite:
In this medical context, 'composite' refers to the amalgamation of various clinical findings or conditions. The report illustrates how two distinct dental issues—amelogenesis imperfecta and localized aggressive periodontitis—can coexist, which underscores the necessity for a comprehensive understanding of each condition in diagnosis and treatment planning.

11) Mutation:
A mutation refers to a change in DNA that can lead to genetic disorders, such as amelogenesis imperfecta. The article discusses potential genetic links between amelogenesis imperfecta and localized aggressive periodontitis, suggesting that ongoing research into these mutations could advance understanding and treatment of these conditions.

12) Bleeding:
Bleeding in the context of periodontal disease is typically a sign of inflammation or advanced tissue damage. The presence of bleeding on probing in the patients indicates active periodontal disease, requiring intervention. It serves as a clinical marker for disease severity and guides treatment decisions.

13) Quality:
Quality pertains to the integrity and characteristics of enamel in the context of amelogenesis imperfecta. The report highlights how the quality of enamel can vary significantly, impacting both its physical properties and aesthetics, and influencing the management of dental health in affected individuals.

14) Mineral:
Mineral primarily refers to the inorganic elements like calcium and phosphate that form the structure of enamel. In amelogenesis imperfecta, the mineralization process is impaired, leading to enamel defects. Understanding the mineral composition is key in evaluating the severity and treatment needs of the condition.

15) Reason:
Reason involves determining the underlying causes of dental conditions. In the case report, the history of environmental or genetic factors contributing to amelogenesis imperfecta is discussed, guiding clinicians in diagnosis and in formulating targeted interventions to mitigate further dental health problems.

16) Medium:
Medium refers to the type of toothbrush or cleaning device used for oral hygiene. In the case report, the patient’s use of a medium bristle toothbrush illustrates the importance of appropriate hygiene tools in maintaining oral health, especially in those with conditions like amelogenesis imperfecta and localized aggressive periodontitis.

17) Fever:
Fever can be a systemic response to infection, although not directly mentioned in the case study, it may indicate underlying issues related to the patients’ periodontal health. Infections associated with periodontal disease can lead to broader health concerns, necessitating an understanding of systemic factors in dental management.

18) Study (Studying):
The term 'study' refers to the broader research efforts that inform clinical practice. The case report discusses prevalence rates and inheritance patterns linked to amelogenesis imperfecta and localized aggressive periodontitis, highlighting the need for ongoing investigation to enhance understanding and improve treatment approaches.

19) Sign:
A 'sign' indicates a clinical indication observable during examination; in the context of the case report, it includes symptoms such as gum inflammation and tooth discoloration. Recognizing these signs is crucial for practitioners in accurately diagnosing dental conditions and planning appropriate interventions.

20) Line:
Line in this context can refer to the line of treatment or the diagnostic guideline followed for amelogenesis imperfecta and periodontal disease. Understanding specific treatment protocols, including surgical and non-surgical options, is vital for managing complex cases presented in the report and ensuring optimal patient outcomes.

21) Pain:
Pain is a key symptom associated with dental disorders and can stem from tooth sensitivity, periodontal inflammation, or other dental health issues. In the context of this case report, addressing pain effectively is crucial for patient comfort and influences the treatment strategy for conditions like localized aggressive periodontitis.

22) Post:
Post refers to the follow-up care necessary after initial treatment. In the case report, regular maintenance programs were implemented post-treatment, emphasizing the importance of ongoing care to monitor patient progress and ensure the longevity of treatment outcomes, especially for complex dental conditions.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Amelogenesis imperfecta and localized aggressive periodontitis.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Family history, Interdisciplinary approach, Environmental factor, Chief complaint, Genetic factor, Treatment planning, Systemic Involvement, Amelogenesis Imperfecta, Periodontal examination, Localized aggressive periodontitis, Carious lesions, Oral hygiene habits.

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