Clinical, Radiographic and Histologic Evaluation of Regional Odontodysplasia: an Unusual Case Report with 6-Year Follow-Up

Background: Regional odontodysplasia is a rare abnormality of unknown aetiology affecting dental tissues derived from the mesoderm and ectoderm. It occurs mostly in women, with no racial predilection. It is often located in the upper jaw and tends to affect a single quadrant. It can involve the temporary as well as the permanent dentition. The aetiology is unknown; however, local, systemic or genetic factors may be involved. The affected teeth are clinically hypoplastic and hypocalcified, radiographically demonstrating the appearance of “ghost teeth”.

Histological Evaluation and Management of Rare Case of Supernumerary “Ghost” Teeth

Supernumerary teeth are teeth that exceed the normal dental formula. Their prevalence in the permanent dentition is 1–14% and they occur more frequently in maxilla with a sex ratio of 2 : 1 in favor of males. They are often associated with syndromes but there are examples of nonsyndromic multiple supernumerary teeth reported in the literature. CBCT is usually the best exam for radiographic diagnosis and treatment planning, because it provides 3D information about location and morphology of supernumerary teeth. This paper reports a rare case of four supernumerary teeth in a nonsyndromic 9-year-old boy. The peculiarity of this case is that two more exceeding teeth were found during surgical procedure. After extraction, all the teeth underwent a histological undecalcified processing for light microscopical examination. The two “ghost” supernumerary teeth seemed to be primordial dental germs, possibly resulting from an altered odontogenic process. After supernumerary teeth extraction, X-rays and exfoliation monitoring are recommended, since permanent retained teeth often erupt naturally or, at least, improve their condition. Radiographic follow-up is also useful in order to assess the formation of further teeth due to the hyperactivity of the dental lamina.

Clinical and Radiographic Findings and Usefulness of Computed Tomographic Assessment in Two Children with Regional Odontodysplasia

Regional odontodysplasia is a rare, severe, and nonhereditary developmental disorder in tooth formation and involves epithelial and mesenchymal-derived dental tissue. On radiographs, affected teeth have an abnormal morphology, a hypoplastic crown, and only a faint outline of hard tissue, a condition termed “ghost teeth.” We report clinical and radiographic findings from two children with regional odontodysplasia. Using computed tomography (CT), we calculated attenuation coefficients (i.e., Hounsfield units) for affected teeth and assessed the condition of dental follicles. To measure density, regions of interest were delimited and CT values were calculated. In our two patients, the CT values for enamel were lower in affected teeth than in sound teeth, while CT values for dentin were similar for affected and sound teeth. The average CT value for dental follicles in affected teeth was about 65 to 120, which suggests that dense fibrous connective tissues or hard tissue-like structures might be present in dental follicles. Analysis of CT values may be quite useful in the diagnosis and treatment of regional odontodysplasia.

Regional Odontodysplasia: Report of a case

Regional odontodysplasia is a rare developmental anomaly involving both mesodermal and ectodermal dental components in groups of contigous teeth. RO affects the primary and permanent dentition in the maxilla and mandible or both jaws. Generally, it is localized in only one arch. The maxillary arch is affected more often than the mandibular arch. The affected teeth tend to be in a consecutive series that does not cross the midline, although some cases do not follow this pattern, as in the present case, have been documented. Radiogaphically wide pulp chambers and thin poorly defined hard tissue outlines described as a "ghost teeth" appearance, are typical features. A case of regional odontodysplasia in a 5 year old male patient is presented. The clinical and radiogaphical findings of this developmental anomaly and treatment are described.