Deciduous teeth structure changes in congenital heart disease: Ultrastructure and microanalysis.

Abstract

Oral manifestations recorded for congenital heart disease (CHD) patients include teeth hypoplasia and high caries incidence. These observations suggested that the enamel and dentin of the teeth may be altered, increasing the risk for caries incidence. This study was designed to investigate the effect of CHD on the ultrastructure and composition of deciduous sound teeth. Thirty sound exfoliated human deciduous incisor teeth were selected for this study. They were divided into three groups, Group I (control) from healthy children (n = 6), Group II from acyanotic CHD children (n = 12) and Group III from cyanotic CHD children (n = 12). Each tooth was longitudinally sectioned, providing enough specimens for ultrastructure and chemical analysis using ESEM/EDAX. The results of ESEM/EDAX and dentin image analysis were statistically analyzed using one-way ANOVA test followed by Tukey's test. Enamel of groups II and III showed increased dissolution and irregular orientation of enamel prisms. Orifices of dentinal tubules demonstrated widening and irregular outlines, also lateral branching increased markedly. Image analysis of dentin ESEM photomicrographs showed a highly significant increase in surface area of dentinal tubules. Decrease in calcium (Ca) and phosphorus (P) levels was statistically significant (P < 0.05). CHDs affect the structure and chemical composition of deciduous teeth.