Regional odontodysplasia: case report and literature review

OBJECTIVES This article describes a clinical case of a 4-year-old boy affected by regional odontodysplasia. The literature review provides epidemi-ological data, and describes clinical features and the treatment plans proposed for this rare anomaly. MATERIALS AND METHODS E.B., a 4-year-old boy, presented for his first dental visit due to sus-pected eruption failure of some deciduous molars. Medical and dental histories were negative. Ex-tra-oral examination does not re-veal abnormalities. Intra-oral ex-amination shows: primary denti-tion, dental plaque accumulation, diastemas and cross bite of the upper right primary canine. The upper right primary molars are partially erupted with malformed hypoplastic brown crowns. In-tra-oral radiography shows hypo -plastic crowns, absence of con-trast between enamel and dentin and short roots. These radiograph-ic features give the teeth the typi-cal "ghost teeth" appearance. The diagnosis of regional odontodys-plasia is made on the basis of clin-ical and radiographic features. The orthopantomography shows de-velopmental delay of the upper right first permanent premolar and molar, which has a malformed crown, and of the upper right sec-ond permanent molar; the tooth bud of the upper right second per-manent premolar is not visible. The mother reports the absence of symptoms. For preventive purpos-es, a glass ionomer sealant is placed. The literature review was conducted on PubMed, Scopus and Google Scholar using the key-words "odontodysplasia", "region-al odontodysplasia", "ghost teeth". Case reports and case series were included.RESULTS After 6 months, the crown of tooth 54 completely broke down and the crown of tooth 55 was mark-edly compromised. The proposed treatment plan involved the ex-traction of the upper right primary molars and the placement of an orthodontic appliance to counter-act the progressive extrusion of the opposing teeth. The literature review includes 132 articles for a total of 168 cases.CONCLUSIONS Regional odontodysplasia is a ra-re development anomaly involving the hard tissues of the teeth that are derived from both epi-thelial and mesenchymal compo-nents of the tooth forming appa-ratus. It is a localized, non-hered-itary with specific histological, clinical and radiographic charac-teristics.