Regional Odontodysplasia: Report of Two Cases and Review of Literature

Abstract

Regional odontodysplasia (RO) is a rare nonhereditary developmental anomaly affecting the formation of dental tissue. Although various theories have been proposed, the etiology is unknown. RO affects both deciduous and permanent dentition, more commonly the anterior maxilla. It is prevalent in females with no racial predilection. It shows unerupted teeth or erupted teeth with small crowns accompanied by abscess and gingival swelling. On radiographs, the affected teeth show thin enamel and dentin with wide pulp chambers commonly described as ghost teeth. The treatment depends on the degree of anomalies, the function, and the esthetics. Here, we report two cases of RO. Case 1: An 8-year-old boy presented with a history of over-retained #F and G, delayed eruption of #9 and 10, and partially erupted hypoplastic #14. On radiographs, teeth #9, 10, and 14 showed large pulp chambers, minimal root development, and a well-defined corticated radiolucency. The patient had multiple follow-up visits over two years. Teeth #F, G, 9, and 10 were extracted along with an excisional biopsy. Histopathologic and radiographic findings were consistent with regional odontodysplasia. Tooth #14 eventually developed dental caries and was extracted. A removable partial denture was fabricated for missing teeth. Case 2: An 11-year-old boy was referred for evaluation of delayed eruption of #25, 26, and 27. Teeth #P, Q, and R were extracted at the age of 6 due to their abnormal appearance and associated pain, however, the alveolar ridge had a good size and contour. On the panoramic radiograph, teeth #25, 26, and 27 were malformed with open apices, large pulp chambers, and a shell-like appearance. The findings were consistent with regional odontodysplasia. The plan was to maintain the unerupted teeth until the patient is old enough to have implants in place, and a removable partial denture was fabricated to replace the unerupted teeth.