Amelogenesis Imperfecta – Types, Symptoms, Causes and Treatment

Amelogenesis Imperfecta (AI) is a rare dental disorder that makes tooth of sufferers yellow in appearance. Read all about the types, causes, symptoms, treatment and more about this disease.

What is Amelogenesis Imperfecta?

It is one of the many rare tooth disorders affecting a small percentage of the population. It affects only 1 out of every 4,000 to 14,000 individuals.

Amelogenesis Imperfecta Etymology

The term “Amelogenesis” is composed of two words, “amelo”  which refers to enamel and “genesis” meaning formation or development. The term “imperfecta” implies “abnormality”. Together, the terms imply an abnormality in the formation of the enamel of the teeth.

Amelogenesis Imperfecta Symptoms

The abnormalities associated with this disorder include the following:

  • Hypoplasia or defect in the amount of the enamel
  • Hypomaturation or defect in the final growth and the maturation of the crystallites enamel
  • Hypcalcification or defect in the initial crystalline formation of the enamel, followed by a defective growth

In any case, all of these three classifications reveals un-mineralized tooth as compared to the normal level of the teeth.

Amelogenesis Imperfecta Causes

The disorder is said to result from genetic factors. The condition is linked to autosomal recessive, x-linked and autosomal dominant conditions. It is reported to be transferred from one generation to another as a dominant genetic trait. This indicates that an individual only requires a copy of the gene from either parent to suffer from the disease.

Amelogenesis Imperfecta Types

The condition is classified into various types, such as:

Type I or Hypoplastic Amelogenesis Imperfecta

This form is manifested by a variety of crown sizes, ranging from small to normal. However, the small teeth reveal a lack of proximal contacts. The color of the teeth may vary from opaque white to normal white to yellow brown. The enamel is noticeably thin and smooth as compared to the normal thickness of teeth. It also displays pits, grooves and furrows.

Type II or Hypomaturation

It is characterized by creamy opaque to yellow or brown teeth surface with soft, rough dental sensitivity of the teeth. The enamel has normal thickness. However, the teeth still break off or wear away easily. Under radio-graphic appearance it also displays a crown that has not erupted yet. Moreover, patients exhibit open bit traits on their mouth.

Type III or Hypocalcification

In this type, the color of teeth ranges from opaque white to yellow brown. The surface of the enamel reveals a soft rough texture. It also shows signs of open bite and dental sensitivity along with heavy calculus formation. The enamel exhibits similar signs with Type III, even under radiographic appearance. However, it is inherited only as an autosomal dominant recessive trait.

Type IV or Hypoplasia/Taurodontism

It reveals white or yellow brown mottled teeth that lack proximal contact and appear small. The enamel is slightly thin and develops large pulp chambers. It has reduced and hyper-mineralized enamel with pits and is inherited through autosomal dominant genes.

Amelogenesis Imperfecta Treatment

The treatment of this condition depends on the type of AI that one is suffering from. This can range from providing preventive care, such as the use of Sealants and Bonding treatment. Fixed prosthetic and extensive removable procedures may also be requested for a better smile and appearance. However, dentists conducting treatment should remember to keep it as simple as possible.

The treatment for two of the main types of Ai is discussed below:

Type I AI Treatment

Based on the characteristics of an AI patient, treatment requires multiple phases to achieve function, esthetics, and maintain its form. This is often done in cases involving AI in children aged two to six years old. However, those aged 6 to 11 may have early mixed dentition, while those aged eleven and higher will be provided with permanent dentition. Restorative care has to be taken into full consideration as the social and psychological development of the child may be in trouble if AI is not treated during their early years. An abnormal set of teeth causes a lot of embarrassment and humiliation to patients, especially during their years of growing up. Permanent dentition may be a bit expensive but can ensure a normal lifestyle for suffering children.

Dental treatment for AI requires collaboration with expert professionals in restorative therapy, such as a Prosthodontist. A surgical or orthodontic intervention may also be required. Due to this reason, an anesthesiologist may also be required prior to dental treatment. A proper evaluation is necessary to guarantee the success of the procedure. Use of operative techniques for AI requires the consent and cooperation of parents during the operation and even after it. Parents and family members should strictly follow the rules and prescriptions given by the dentist to guarantee faster healing and recovery.

Hypoplastic AI Treatment

This type of treatment is more suitable for restorative forms of therapies, such as bonding teeth to the enamel. The material used may be made of porcelain or composite resin, so that it can easily be bonded to the anterior part of the teeth. The shape, size and color may need to be slightly altered. Orthodontic therapy may also be used so that the interdental spaces may be partially close. There are no issues in using existing amalgams and composite resins on the tooth. Nevertheless, malformed teeth may need a full dental coverage so that crowns may be placed for the assistance of dentures and the like.

Patients suffering from malocclusions need not worry as it can be treated using braces. The process does not use traditional methods. Rather, it involves covering the teeth with crowns before orthodontic braces are applied. If the patient displays extreme case of skeletal open bite, orthognatic surgery may be required for the optimum alignment of the jaws and the teeth. However, orthodontic braces are not used as part of treatment until patients become adolescents. This is necessary to guarantee that the teeth and the jaw develop fully.

Amelogenesis Imperfecta Prevention

Calculus deposits are more prominent with AI. This makes it all the more necessary for affected children to practice strict oral hygiene because of the rough enamel surface and altered salivary flow rate (due to dental sensitivity). They may need to visit dentists more frequently for cleaning and evaluation. Deep scaling may be done to keep off deposits. Proper dental hygiene will guarantee the health of your teeth and gingiva.

Researchers are still trying to understand this condition better. Treatment procedures and evaluative processes are constantly being reviewed to bring out the best options for Amelogenesis imperfecta, especially in children.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/001578.htm

http://ghr.nlm.nih.gov/condition/amelogenesis-imperfecta

http://www.umm.edu/ency/article/001578.htm

http://www.dentistry.unc.edu/research/defects/pages/ai.htm

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